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Eur J Cardiothorac Surg 2006;29:299-303
© 2006 Elsevier Science NL

Reversed remodelling in dilated cardiomyopathy by passive containment surgery is associated with decreased circulating levels of endothelin-1

Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, S-171 76 Stockholm, Sweden

Received 16 September 2005; received in revised form 8 December 2005; accepted 9 December 2005.

^_* Corresponding author. Tel.: +46 8 517 791 77; fax: +46 8 32 27 01. (Email: fredrik.bredin{at}karolinska.se).

Objective: To evaluate the influence on circulating levels of endothelin-1 and big endothelin-1 in relation to echocardiographic findings and functional assessment, by passive containment surgery in heart failure patients with dilated cardiomyopathy. Methods: Thirteen patients with dilated cardiomyopathy subjected to cardiac surgery received the Acorn Cardiac Support Device. Patients with ischemic dilated cardiomyopathy (n = 6) underwent coronary artery bypass surgery receiving one to three bypass grafts. In the idiopathic dilated cardiomyopathy group (n = 7), mitral valve plasty was performed in five patients while two patients received the cardiac support device only. Circulating plasma levels of endothelin-1 and big endothelin-1 were measured in all patients before surgery and 12 months after surgery. Concomitantly New York Heart Association functional class and 6-min walk were evaluated and cardiac dimensions measured with echocardiography. Results: Following surgery there was a significant decrease in circulating plasma levels of endothelin-1 (5.9 ± 0.6 pM preoperatively vs 4.3 ± 0.3 pM postoperatively, P < 0.05). New York Heart Association functional class improved (2.8 ± 0.2 preoperatively vs 1.8 ± 0.2 postoperatively, P < 0.05). The 6-min walk increased (384 ± 24 m preoperatively vs 465 ± 33 m postoperatively, P < 0.05). There was also a decrease in left ventricular end diastolic diameter (69 ± 2 mm preoperatively vs 62 ± 2 mm postoperatively, P < 0.05) and left ventricular end systolic diameter (60 ± 2 mm preoperatively vs 54 ± 3 mm postoperatively, P < 0.05). Linear correlation revealed a relationship between decreased left ventricular end diastolic diameter and decreased endothelin-1 levels (R = 0.56; P < 0.05). Conclusions: Following passive containment surgery using the Acorn Cardiac Support Device there is a decrease in circulating levels of endothelin-1 concomitant with a decrease in cardiac dimensions and function improvement.

Key Words: Cardiac support device • Dilated cardiomyopathy • Heart failure • Endothelin

This article has been cited by other articles:

				F. Bredin, A. Olsson, and A. Franco-Cereceda No Additive Effect of Passive Containment Surgery in Patients With Aortic Regurgitation and Left Ventricular Dilation Ann. Thorac. Surg., August 1, 2007; 84(2): 510 - 513. [Abstract] [Full Text] [PDF]