OBJECTIVE: To identify the effects of the time between myocardial infarction and surgery, the site of infarction, mitral involvement on ventricular geometry, and clinical outcome in the treatment of ischemic cardiomyopathy in patients with heart failure. METHODS: Sixty-nine consecutive patients with ischemic cardiomyopathy, indexed end-systolic volume > or =50 mL/m(2), ejection fraction < or =35%, and heart failure underwent surgery 81.9 +/- 100.8 months after myocardial infarction, using different techniques of ventricular restoration. Thirteen geometric parameters were studied pre- and postoperatively. Paired and unpaired t tests and general linear model for multivariate analysis were used to analyze subgroups. Logistic regression and Kaplan-Meier survival curves with pairwise log-rank were used to correlate covariates to clinical outcome. RESULTS: Longer time to surgery and posterior necrosis linearly correlated with higher left ventricular volumes (r(2) =.66) and diameters (r(2) =.40). High grade of mitral regurgitation was always present in posterior infarctions. Hospital mortality was 4.3%. Complicated postoperative course was predicted by mitral surgery (P =.004) and longer time to surgery (P =.04). Survival was significantly lower in the posterior infarction (P =.0002) and mitral surgery (P =.001) subgroups. At a mean follow-up of 1.9 +/- 1.3 years, functional status and geometrical restoration are influenced by the studied covariates. CONCLUSIONS: Longer time to surgery after myocardial infarction, its posterior location, and significant mitral regurgitation can affect left ventricular remodeling, surgical restoration, and clinical outcome in patients with ischemic cardiomyopathy.
OBJECTIVE: To identify the effects of the time between myocardial infarction and surgery, the site of infarction, mitral involvement on ventricular geometry, and clinical outcome in the treatment of ischemic cardiomyopathy in patients with heart failure. METHODS: Sixty-nine consecutive patients with ischemic cardiomyopathy, indexed end-systolic volume > or =50 mL/m(2), ejection fraction < or =35%, and heart failure underwent surgery 81.9 +/- 100.8 months after myocardial infarction, using different techniques of ventricular restoration. Thirteen geometric parameters were studied pre- and postoperatively. Paired and unpaired t tests and general linear model for multivariate analysis were used to analyze subgroups. Logistic regression and Kaplan-Meier survival curves with pairwise log-rank were used to correlate covariates to clinical outcome. RESULTS: Longer time to surgery and posterior necrosis linearly correlated with higher left ventricular volumes (r(2) =.66) and diameters (r(2) =.40). High grade of mitral regurgitation was always present in posterior infarctions. Hospital mortality was 4.3%. Complicated postoperative course was predicted by mitral surgery (P =.004) and longer time to surgery (P =.04). Survival was significantly lower in the posterior infarction (P =.0002) and mitral surgery (P =.001) subgroups. At a mean follow-up of 1.9 +/- 1.3 years, functional status and geometrical restoration are influenced by the studied covariates. CONCLUSIONS: Longer time to surgery after myocardial infarction, its posterior location, and significant mitral regurgitation can affect left ventricular remodeling, surgical restoration, and clinical outcome in patients with ischemic cardiomyopathy.
Authors: Jae K Oh; Eric J Velazquez; Lorenzo Menicanti; Gerald M Pohost; Robert O Bonow; Grace Lin; Anne S Hellkamp; Paolo Ferrazzi; Stanislaw Wos; Vivek Rao; Daniel Berman; Andrzej Bochenek; Alexander Cherniavsky; Jan Rogowski; Jean L Rouleau; Kerry L Lee Journal: Eur Heart J Date: 2012-05-14 Impact factor: 29.983
Authors: David L Prior; Susanna R Stevens; Thomas A Holly; Michal Krejca; Alexandros Paraforos; Gerald M Pohost; Krysti Byrd; Tomasz Kukulski; Robert H Jones; Patrice Desvigne-Nickens; Padmini Varadarajan; Aman Amanullah; Grace Lin; Hussein R Al-Khalidi; Gabriel Aldea; Carlo Santambrogio; Andrzej Bochenek; Daniel S Berman Journal: Heart Date: 2017-04-26 Impact factor: 5.994
Authors: Yanping Cheng; Michael S Aboodi; Andrew S Wechsler; Greg L Kaluza; Juan F Granada; Kevin Van Bladel; Lon S Annest; Geng-Hua Yi Journal: Interact Cardiovasc Thorac Surg Date: 2013-08-28
Authors: Avan Suinesiaputra; Pierre Ablin; Xenia Alba; Martino Alessandrini; Jack Allen; Wenjia Bai; Serkan Cimen; Peter Claes; Brett R Cowan; Jan D'hooge; Nicolas Duchateau; Jan Ehrhardt; Alejandro F Frangi; Ali Gooya; Vicente Grau; Karim Lekadir; Allen Lu; Anirban Mukhopadhyay; Ilkay Oksuz; Nripesh Parajali; Xavier Pennec; Marco Pereanez; Catarina Pinto; Paolo Piras; Marc-Michel Rohe; Daniel Rueckert; Dennis Saring; Maxime Sermesant; Kaleem Siddiqi; Mahdi Tabassian; Luciano Teresi; Sotirios A Tsaftaris; Matthias Wilms; Alistair A Young; Xingyu Zhang; Pau Medrano-Gracia Journal: IEEE J Biomed Health Inform Date: 2017-01-17 Impact factor: 5.772