Literature DB >> 25779355

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

Jin-Oh Choi1, Richard C Daly, Grace Lin, Brian D Lahr, Heather J Wiste, Thomas M Beaver, Attilio Iacovoni, Marcin Malinowski, Ivar Friedrich, Jean L Rouleau, Roberto R Favaloro, George Sopko, Irene M Lang, Harvey D White, Carmelo A Milano, Robert H Jones, Kerry L Lee, Eric J Velazquez, Jae K Oh.   

Abstract

AIMS: We sought to evaluate associations between baseline sphericity index (SI) and clinical outcome, and changes in SI after coronary artery bypass graft (CABG) surgery with or without surgical ventricular reconstruction (SVR) in ischaemic cardiomyopathy patients enrolled in the SVR study (Hypothesis 2) of the Surgical Treatment for Ischemic Heart Failure (STICH) trial. METHODS AND
RESULTS: Among 1000 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 vs. 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 EF improved significantly more in the CABG + SVR group compared with CABG alone, the severity of mitral regurgitation significantly improved only in the CABG alone group, and the 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 LVEF and smaller LV volume. Survival was significantly better in patients with lower SI regardless of treatment strategy.
© 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology.

Entities:  

Keywords:  Sphericity index; Surgical ventricular reconstruction and STICH

Mesh:

Year:  2015        PMID: 25779355      PMCID: PMC4664050          DOI: 10.1002/ejhf.256

Source DB:  PubMed          Journal:  Eur J Heart Fail        ISSN: 1388-9842            Impact factor:   15.534


  18 in total

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3.  Influence of baseline left ventricular function on the clinical outcome of surgical ventricular reconstruction in patients with ischaemic cardiomyopathy.

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10.  Relation of left ventricular sphericity to 10-year survival after acute myocardial infarction.

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Journal:  Am J Cardiol       Date:  2004-11-15       Impact factor: 2.778

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7.  Surgical Ventricular Restoration for Ischemic Heart Failure: A Glance at a Real-World Population.

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