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. 2000 Mar;83(3):316–319. doi: 10.1136/heart.83.3.316

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

S Gradinac 1
PMCID: PMC1729328  PMID: 10677413

Abstract

OBJECTIVE—To assess the effect of partial left ventriculectomy (PLV) on estimate 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 measurements of femoral artery pressure was performed during right heart pacing before and after load reduction.
RESULTS—PLV increased mean (SD) Ees from 0.52 (0.27) to 1.47 (0.62) mm Hg/ml (p = 0.0004). The increase in Ees remained significant after correction for the change in left ventricular mass (p = 0.004) and end diastolic volume (p = 0.048). As PLV had no effect on arterial elastance, ventriculoarterial coupling improved from 3.25 (2.17) to 1.01 (0.93) (p = 0.017), thereby maximising left ventricular stroke work.
CONCLUSION—It appears that PLV improves both Ees and ventriculoarterial coupling, thus increasing left ventricular work efficiency.


Keywords: dilated cardiomyopathy; elastance; partial left ventriculectomy

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Figure 1  .

Figure 1  

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Effect of PLV on Ees, an estimate of left ventricular end systolic elastance. There was a substantial improvement of Ees (p = 0.0004) (A). Improvement of Ees by PLV persisted after multiplying Ees with left ventricular mass (Ees*LV mass) (p = 0.004) (B), and after multiplying Ees with left ventricular end diastolic volume (Ees*LV EDV) (p = 0.048) (C).

Figure 2  .

Figure 2  

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Individual left ventricular (LV) end systolic pressure-volume relations in (A) patients with no or mild mitral regurgitation (n = 6), and (B) patients with severe mitral regurgitation (n = 5). End systolic elastance was higher in patients with no or mild mitral regurgitation both pre- and postoperatively (p = 0.02 by analysis of variance (ANOVA)), while its increase was similar in both groups (p > 0.05 by ANOVA). Dashed lines denote preoperative values, whereas solid lines denote postoperative values. The markers are the same for individual patients pre- and postoperatively.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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