Partial left ventriculectomy improves left ventricular end systolic elastance in patients with idiopathic dilated cardiomyopathy

Objective-To assess the effect of partial left ventriculectomy (PLV) on est imate of left ventricular end systolic elastance (Ees), arterial elastance, and ventriculoarterial coupling. Patients-11 patients with idiopathic dilated cardiomyopathy before and two weeks after PLV, and 11 controls. Interventions-Single plane left ventricular angiography with simultaneous m easurements of femoral artery pressure was performed during right heart pac ing before and after load reduction. Results-PLV increased mean (SD) Ees from 0.52 (0.27) to 1.47 (0.62) mm Hg/m l (p = 0.0004). The increase in Ees remained significant after correction f or the change in left ventricular mass (p = 0.004) and end diastolic volume (p = 0.048). As PLV had no effect on arterial elastance, ventriculoarteria l coupling improved from 3.25 (2.17) to 1.01 (0.93) (p 0.017), thereby maxi mising left ventricular stroke work. Conclusion-It appears that PLV improves both Ees and ventriculoarterial cou pling, thus increasing left ventricular work efficiency.