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Published on: May 13, 2019
Changes in right ventricular dimensions and performance after passive cardiac containment
Alexander Lembcke1, Simon Dushe, Steffen Sonntag
1Department of Radiology, Charité Medical School, Humboldt-Universität, Berlin, Germany. Alexander.lembcke@gmx.de
Insights
The cardiac support device (CSD) reduces right ventricle (RV) size and improves its function in heart failure patients. This biventricular recovery complements previous findings on left ventricular improvements with CSD therapy.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Previous research indicates cardiac support device (CSD) benefits left ventricular function in heart failure.
- This study investigates the impact of CSD on right ventricular (RV) structure and function.
Observation:
- Ten male patients with idiopathic dilated cardiomyopathy were assessed using electron-beam computed tomography (CT) before and after CSD implantation.
- Key RV parameters including volumes, diameters, stroke volume, ejection fraction, and output were measured.
Findings:
- CSD implantation significantly decreased RV end-diastolic and end-systolic volumes and diameters.
- RV ejection fraction and forward output improved post-implantation, with no significant change in stroke volume or total output.
- Tricuspid regurgitation fraction was reduced, and postoperative RV function normalized compared to controls.
Implications:
- CSD therapy promotes a biventricular recovery in heart failure patients.
- These findings suggest CSD is effective in improving both left and right heart function.
- CSD offers a potential therapeutic strategy for managing biventricular heart failure.
Background:
Previous studies have shown that the cardiac support device (CSD) improves left ventricular structure and function in patients with heart failure by preventing further cardiac enlargement. The aim of this study was to identify effects on the right ventricle (RV).
Methods:
Ten male patients with idiopathic dilated cardiomyopathy underwent electron-beam computed tomographic (CT) examination within 1 month before, and 6 to 9 months after CSD implantation. The RV end-diastolic and end-systolic volumes (EDV, ESV) and diameters (EDD, ESD), stroke volume (SV), ejection fraction (EF), total and forward RV output (RVO, fRVO), and tricuspid regurgitation fraction (TRF) were calculated.
Results:
The EDV measurements decreased from 182.1 +/- 49.6 to 137.5 +/- 37.0 mL, ESV from 114.8 +/- 47.0 to 68.3 +/- 23.8 mL, EDD from 48.2 +/- 6.6 to 41.6 +/- 7.1 mm, and ESD from 39.6 +/- 6.9 to 32.7 +/- 6.5 mm (p < 0.05 for each). Ejection fraction increased from 38.5 +/- 8.9 to 52.0% +/- 7.7% and fRVO from 4.0 +/- 0.8 to 4.6 +/- 1.1 L/min (each with p < 0.05). TRF decreased from 18.2 +/- 14.1 to 10.4% +/- 13.5%, whereas SV and RVO remained nearly unchanged. Postoperatively, RV volumes, EF, and fRVO were not different from 15 age- and gender-matched normal control patients.
Conclusions:
Implantation of a CSD leads to a decrease in RV size and improved RV performance. These data together with the results of previous studies demonstrating improved left ventricular structure and function confirm the biventricular nature of recovery with the CSD.
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