Effects of surgical ventricular reconstruction on diastolic function at midterm follow-up

Donato, Marisa Di; Menicanti, Lorenzo; Ranucci, Marco; Castelvecchio, Serenella; Vincentiis, Carlo De; Salvia, Josephal; Yussuf, Tammam

doi:10.1016/j.jtcvs.2009.10.027

Cited by 19 publications

(17 citation statements)

References 22 publications

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“…Considering that diastolic function is usually more related to the longitudinal motion of the left ventricle, findings that the reduction in LV long‐axis dimension and increased SI were associated with worsening grades of diastolic dysfunction are noteworthy . Indeed, as the left ventricle becomes more globular, LV wall tension generally increases and is followed by more severe diastolic dysfunction and/or mitral regurgitation, which was consistent in the current data . Increased LV wall tension could also have adverse effects on myocardial blood flow .…”

Section: Discussionsupporting

confidence: 89%

“…However, there were controversies about the usefulness of this procedure, with the only previous study of a small number of patients showing that SI became worse after SVR. 14,16 In this analysis of STICH data, LV end-systolic and diastolic volumes were reduced and LVEF improved after CABG + SVR, as expected. The decrease of LV volume after SVR was probably due to reduction in the LV long-axis dimension as there was only an insignificant decrease in short-axis dimension.…”

Section: Discussionsupporting

confidence: 78%

“…Initially, SVR was believed to reverse LV remodelling by eliminating the akinetic or dyssynergic zone of the left ventricle and therefore reducing LV cavity size with a more efficient shape. However, there were controversies about the usefulness of this procedure, with the only previous study of a small number of patients showing that SI became worse after SVR . In this analysis of STICH data, LV end‐systolic and diastolic volumes were reduced and LVEF improved after CABG + SVR, as expected.…”

Section: Discussionsupporting

confidence: 68%

“…17 Indeed, as the left ventricle becomes more globular, LV wall tension generally increases and is followed by more severe diastolic dysfunction and/or mitral regurgitation, which was consistent in the current data. 14,18,19 Increased LV wall tension could also have adverse effects on myocardial blood flow. 20 This counter-intuitive change in LV shape towards a less efficient globular shape after SVR was evident irrespective of the baseline LVESV index (Figure 4).…”

Section: Discussionmentioning

confidence: 99%

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Impact of surgical ventricular reconstruction on sphericity index in patients with ischaemic cardiomyopathy: follow‐up from the STICH trial

Choi

Daly

Lin

et al. 2015

European J of Heart Fail

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Aims We sought to evaluate associations between baseline sphericity index (SI) and clinical outcome, and changes in SI after coronary artery bypass graft surgery (CABG) with or without surgical ventricular reconstruction (SVR) in ischemic cardiomyopathy patients enrolled in the SVR study (Hypothesis 2) of the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Methods and results Among 1,000 patients in the STICH SVR study, we evaluated 546 patients (255 randomized to CABG alone and 291 to CABG+SVR) whose baseline SI values were available. SI was not significantly different between treatment groups at baseline. After 4 months, SI had increased in the CABG+SVR group, but was unchanged in the CABG alone group (0.69 ± 0.10 to 0.77 ± 0.12 versus 0.67 ± 0.07 to 0.66 ± 0.09, respectively; P < 0.001). SI did not significantly change from 4 months to 2 years in either group. Although LV end-systolic volume and ejection fraction improved significantly more in the CABG+SVR group compared to CABG alone, the severity of mitral regurgitation significantly improved only in the CABG alone group and estimated LV filling pressure (E/A ratio) increased only in the CABG+SVR group. Higher baseline SI was associated with worse survival after surgery (hazard ratio = 1.21, 95% confidence interval = 1.02−1.43; P = 0.026). Survival was not significantly different by treatment strategy. Conclusion Although SVR was designed to improve LV geometry, SI worsened after SVR despite improved LV ejection fraction and smaller LV volume. Survival was significantly better in patients with lower SI regardless of treatment strategy. (THE STICH TRIAL: Surgical Treatment for Ischemic Heart Failure trial; NCT00023595)

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of surgical ventricular reconstruction on sphericity index in patients with ischaemic cardiomyopathy: follow‐up from the STICH trial

Choi

Daly

Lin

et al. 2015

European J of Heart Fail

View full text Add to dashboard Cite

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“…Alterations of the geometric shape of the left and right ventricles have been reported in adult and pediatric patients as markers of cardiac dysfunction in which the ventricle appears to be flattened or rounded, depending on the underlying abnormality . One method used for evaluation of ventricular shape involves measuring the end‐diastolic BAL and TL for the right and left ventricular chambers and computing the GSI using either BAL/TL or TL/BAL (Figure ) …”

Section: Discussionmentioning

confidence: 99%

Abnormal Fetal Findings Associated With a Global Sphericity Index of the 4‐Chamber View Below the 5th Centile

DeVore

Satou

Sklansky

2017

J of Ultrasound Medicine

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Post‐COVID‐19 Fetal Cardiac Morphology and Systolic Evaluation in Infected Pregnant Women by Fetal Heart Quantification Technology

Zhu,

Zhao,

et al. 2024

J of Ultrasound Medicine

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ObjectivesDue to the government's liberalization of epidemic control, the current 2019 novel coronavirus disease (COVID‐19) has started to spread widely within China. This study aimed to use the fetal heart quantification (fetal HQ) technique to assess the cardiac function and morphology of the fetuses of pregnant women diagnosed with COVID‐19 in the early stages of pregnancy.MethodsExactly 86 pregnant women diagnosed with COVID‐19 infection in early pregnancy (COVID‐19 group) and 90 healthy pregnant women (control group) who underwent fetal echocardiography were prospectively included in this study. The fetal HQ technique was applied to compare the differences in the global sphericity index (GSI), global strain values (GS), fractional area change (FAC), and 24‐segment fractional shortening (FS) of the left and right ventricles, between the COVID‐19 group and the control group.ResultsCompared with the control group, the differences in GS and 24‐segment FS of the left ventricle in the COVID‐19 group were not statistically significant. However, the COVID‐19 group showed lower GSI values compared with the control group (1.24 vs 1.28). FAC (48.12%) of the left ventricle and GS (−23.55%), FAC (41.74%) of the right ventricle in the COVID‐19 group were reduced compared with FAC (50.50%) of the left ventricle and GS (−27.63%), FAC (46.01%) of the right ventricle in the control group. Segmental analysis revealed reduced FS in segments 20–24 in the COVID‐19 group compared with the control group. Right ventricular GS was an independent predictor of adverse pregnancy outcome with an optimal cutoff value of −18.66%.ConclusionsThe results suggest that COVID‐19 infection in early pregnancy may have a negative impact on fetal cardiac morphology and function. Fetal HQ may offer a new assessment method for the early identification of fetal cardiac alterations in pregnant women infected with COVID‐19.

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Effects of surgical ventricular reconstruction on diastolic function at midterm follow-up

Abstract: Mild preoperative diastolic dysfunction (pseudonormalized pattern) and increased septolateral dimensions are independent predictors of diastolic restriction after surgical ventricular reconstruction.

Cited by 19 publications

References 22 publications

Impact of surgical ventricular reconstruction on sphericity index in patients with ischaemic cardiomyopathy: follow‐up from the STICH trial

Impact of surgical ventricular reconstruction on sphericity index in patients with ischaemic cardiomyopathy: follow‐up from the STICH trial

Abnormal Fetal Findings Associated With a Global Sphericity Index of the 4‐Chamber View Below the 5th Centile

Post‐COVID‐19 Fetal Cardiac Morphology and Systolic Evaluation in Infected Pregnant Women by Fetal Heart Quantification Technology

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