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Eur J Cardiothorac Surg 2001;19:61-67
© 2001 Elsevier Science NL

Functional capacity late after partial left ventriculectomy: relation to ventricular geometry and performance

Z. Popovi^a, M. Miri^b, A.N. Nekovi^a, J. Vasiljevi^b, P. Otaevi^a, M. arkovi^c, M. Boji^a, S. Gradinac^d

^a "Dr. Aleksandar D. Popovi" Cardiovascular Research Center, Dedinje Cardiovascular Institute, Milana Tepia 1, 11040 Belgrade, Yugoslavia
^b Department of Cardiology, Dedinje Cardiovascular Institute, Belgrade, Yugoslavia
^c Institute of Endocrinology, Clinical Center of Serbia, Belgrade University School of Medicine, Belgrade, Yugoslavia
^d Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Yugoslavia

Received 7 August 2000; received in revised form 21 October 2000; accepted 22 October 2000.

Corresponding author. Tel.: +381-11-628-207; fax: +381-11-666-392
e-mail: sconic{at}eunet.yu

Objectives: While partial left ventriculectomy (PLV) may improve functional status, the duration and determinants of this improvement are poorly known. This study sought to assess the relationship between left ventricular (LV) shape and function and functional status in late survivors after PLV for non-ischemic dilated cardiomyopathy (DCM). Methods: We assessed the relations between LV shape and function and functional status in 17 consecutive patients who survived >12 months after PLV for non-ischemic DCM. Invasive diagnostic studies were performed before, early after, at mid-term after, and late after PLV. According to their functional status after >12 months of follow-up, patients were divided into responders (n=10) or non-responders (n=7). Results: After PLV, the LV systolic major-to-minor axis ratio was higher in responders at early, mid-, and late follow-up (P=0.003, P=0.008 and P=0.04, respectively). LV circumferential end-diastolic stress decreased early after PLV, but increased afterwards in non-responders only (P=0.049). LV ejection fraction was similar in the two groups at baseline, and at early and mid-follow-up, but was lower in non-responders at late follow-up (P=0.006). However, LV end-diastolic and end-systolic volumes, and LV end-systolic circumferential stress showed no difference between the two groups. Conclusions: It appears that poor functional capacity in late post-PLV survivors is related to postoperative LV geometry.

Key Words: Heart failure • Partial left ventriculectomy • Left ventricular performance

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