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[Reversal of severe left ventricular dilatation after operation and its correlation with cardiac function]
1Department of Cardiac Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.
Objective:
To investigate the relationship between the reversal of left ventricular dilatation and postoperative cardiac function, and prognosis.
Methods:
16 patients with severely dilated left ventricle underwent echocardiographic examinations preoperatively and at discharge (7 - 10 days after operation). Left ventricular (LV) diameters were measured (LVEDD, LVESD) and matched to body surface area (LVEDDI, LVESDI) and fractional shortening (FS); left ventricular ejection fraction (EF) was calculated.
Results:
Left ventricular dimensions significantly decreased at discharge after operation. Preoperative LVEDD was (78.54 +/- 6.30) mm and postoperative LVEDD (63.77 +/- 13.69) mm (P < 0.01). Preoperative LVESD (60.03 +/- 8.95) mm and postoperative LVESD (53.23 +/- 12.68) mm (P < 0.05). Preoperative LVEDDI was (44.10 +/- 5.24) mm/m(2) and postoperative LVEDDI (36.01 +/- 9.53) mm/m(2) (P < 0.01). Preoperative LVESDI was (34.78 +/- 6.22) mm/m(2) and postoperative LVESDI (30.90 +/- 9.19) mm/m(2) (P < 0.05). Left atrium (LA) dimension was shorter after operation than before operation. Left ventricular construction didn't improve postoperatively, even temporarily decreased at discharge. Preoperative EF was (48.00 +/- 11.71)% and postoperative EF (40.15 +/- 8.69)% (P < 0.01). Preoperative FS was (22.82 +/- 6.27)% and postoperative FS (19.63 +/- 3.42) (P > 0.05). The incidence of postoperative cardiac arrhythmia was 75%. No dimension changes were observed in 2 patients with severely dilated left ventricles after operation: one (LVEDDI 56 mm/m(2)) died, and the other had severe low cardiac output. Six of 14 who had reduced dilated left ventricle didn't reach normal limits, still in the range of severe dilated left ventricule (LVEDDI > 37 mm/m(2)).
Conclusions:
Most patients decreased the dimension of left ventricular size early after operation, but some had partial recovery from severe ventricular dilatation. Although left ventricular dimensions (LVEDD, LVESD, LVEDDI, LVESDI) significantly reduced, cardiac function didn't improve at once with the reversal of left ventricular dilatation, but temporarily decreased after operation and the incidence of cardiac arrhythmia was high.