Partial left ventriculectomy in severe idiopathic dilated cardiomyopathy: Assessment of short-term results and their impact on late survival by magnetic resonance imaging

We evaluated short-term effects of partial ventriculectomy on left ventricu lar (LV) parameters and its impact on late survival by magnetic resonance i maging (MRI). Twenty patients and 10 normal volunteers were studied, and LV volumes (EDV, ESV), ejection fraction (EF), short- and long-axis dimension s (SA, IA), wall thickness (Wth), shape (LA/SA), geometry (Wth/SA), a geome try index (Phi), and wall-motion score index (WMSI) were evaluated pre- and postoperatively. Also, we compared results and survival of patients with p reoperative EF less than or equal to 17% vs. EF > 17%. Short-term results s howed significant changes (P < 0.001) in: EF (17.3 +/- 7.3% vs. 30.4 +/- 9. 5%), EDV (391.9 +/- 118 vs. 272.7 +/- 90 mL); ESV (308.2 +/- 102.8 vs. 190. 3 +/- 68.4 mL); SA (80.5 +/- 10.4 vs. 71.7 +/- 7.8 mm); LA/SA (1.13 +/- 0.1 vs. 1.34 +/- 0.1); Wth (8.35 +/- 0.99 vs. 9.75 +/- 1.41 mm); Wth/SA (0.10 +/- 0.01 vs. 0.14 +/- 0.02), diastolic( 0.80 +/- 0.16 vs. 0.58 +/- 0.13) an d systolic (0.78 +/- 0.18 vs. 0.55 +/- 0.12) Phi; and WMSI (-2 vs. -1) (P = 0.032). The EF division showed differences in: LA/SA (1.26 +/- 0.10 vs. 1. 49 +/- 0.12) (P < 0.001); Wth/SA (0.13 +/- 0.02 vs. 0.15 +/- 0.02) (P = 0.0 23); diastolic (0.65 +/- 0.11 vs. 0.48 +/- 0.11) and systolic (0.63 +/- 0.0 9 vs. 0.46 +/- 0.09) Phi (P < 0.001); and WMSI (-2 vs. -1) (P = 0.033). Fin ally, correlation between pre/postoperative EF showed for EF < 17%, r = 0.3 2 and for EF > 17%, r = 0.83, which had different late survival. Our study showed significant changes on IV parameters after ventriculectomy. Patients with EF > 17% showed better EF correlation between pre/postoperative value s and higher survival rate. (C) 2001 Wiley-Liss, Inc.