Fabio Fantini1, Anna Toso2, Lorenzo Menicanti3, Francesco Moroni4, Serenella Castelvecchio3. 1. Department of Cardiology, University of Florence, Florence, Italy. 2. Division of Cardiology, Santo Stefano Hospital, Prato, Italy. Electronic address: anna.toso@libero.it. 3. Cardiac Surgery Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, San Donato Milanese, Italy. 4. Cardiothoracic and Cardiovascular Department, IRCCS Vita-Salute University San Raffaele, Milan, Italy.
Abstract
OBJECTIVE: To examine factors possibly involved in the resolution or persistence of restrictive filling pattern (RFP) after surgical ventricular restoration (SVR) in a series of patients with ischemic cardiomyopathy (ICM) and RFP. METHODS: Echocardiography was performed at baseline (pre-SVR), discharge, and follow-up in 43 patients with ICM and RFP (E/A ratio ≥2). Patients were divided into 2 groups based on E/A ratio at discharge: improved (E/A ratio <2; 22 patients) and unchanged (E/A ratio ≥2; 21 patients). RESULTS: The improved group had a significantly increased mean deceleration time (from 137 ± 22 ms to 194 ± 68 ms; P = .002) and mean A wave velocity (from 43 ± 10 cm/s to 92 ± 37 cm/s; P = .001), and decreased E/e' ratio (from 27.7 ± 9.5 to 19.2 ± 7.8; P = .01) after SVR. The unchanged group did not show any significant variations in diastolic parameters. The only significant differences at baseline between the two groups were thinner left ventricle posterior wall and lower relative wall thickness (RWT) in the unchanged group. RWT was the sole baseline parameter independently associated with persistent RFP. CONCLUSIONS: RFP was reversed after SVR in 22 of our 43 patients with ICM with a response that remained stable over time, associated with improved New York Heart Association class. RWT was the sole baseline echocardiographic parameter significantly associated with the evolution of RFP after SVR.
OBJECTIVE: To examine factors possibly involved in the resolution or persistence of restrictive filling pattern (RFP) after surgical ventricular restoration (SVR) in a series of patients with ischemic cardiomyopathy (ICM) and RFP. METHODS: Echocardiography was performed at baseline (pre-SVR), discharge, and follow-up in 43 patients with ICM and RFP (E/A ratio ≥2). Patients were divided into 2 groups based on E/A ratio at discharge: improved (E/A ratio <2; 22 patients) and unchanged (E/A ratio ≥2; 21 patients). RESULTS: The improved group had a significantly increased mean deceleration time (from 137 ± 22 ms to 194 ± 68 ms; P = .002) and mean A wave velocity (from 43 ± 10 cm/s to 92 ± 37 cm/s; P = .001), and decreased E/e' ratio (from 27.7 ± 9.5 to 19.2 ± 7.8; P = .01) after SVR. The unchanged group did not show any significant variations in diastolic parameters. The only significant differences at baseline between the two groups were thinner left ventricle posterior wall and lower relative wall thickness (RWT) in the unchanged group. RWT was the sole baseline parameter independently associated with persistent RFP. CONCLUSIONS: RFP was reversed after SVR in 22 of our 43 patients with ICM with a response that remained stable over time, associated with improved New York Heart Association class. RWT was the sole baseline echocardiographic parameter significantly associated with the evolution of RFP after SVR.
Authors: Olena Nemchyna; Natalia Solowjowa; Michael Dandel; Yuriy Hrytsyna; Julia Stein; Jan Knierim; Felix Schoenrath; Felix Hennig; Volkmar Falk; Christoph Knosalla Journal: Front Cardiovasc Med Date: 2022-03-21
Authors: Joshua G Travers; Sara A Wennersten; Brisa Peña; Rushita A Bagchi; Harrison E Smith; Rachel A Hirsch; Lauren A Vanderlinden; Ying-Hsi Lin; Evgenia Dobrinskikh; Kimberly M Demos-Davies; Maria A Cavasin; Luisa Mestroni; Christian Steinkühler; Charles Y Lin; Steven R Houser; Kathleen C Woulfe; Maggie P Y Lam; Timothy A McKinsey Journal: Circulation Date: 2021-03-08 Impact factor: 29.690