[The value of isotopic ventriculography in the prognosis and follow-up of patients undergoing dynamic myocardioplasty].
Dynamic cardiomyoplasty was performed in twenty patients with dilated cardiomyopathy. The electrical stimulation was produced by a double chambered pacemaker. Patients were studied by nuclear ventriculography one week before surgery, in the immediate postoperative phase and 8 or 12 months later. Five patients died (four of them were operative deaths). In this group the left ventricular ejection fraction (LVEF) was lower than in survivors (22 +/- 8% vs 28 +/- 4%; p less than 0.001). The end-diastolic volume and the mitral regurgitation index were greater (200 +/- 76 ml/m2 vs 153 +/- 34 ml/m2; p less than 0.001 and 2.12 +/- 0.75 vs 1.68 +/- 0.54; p less than 0.001, respectively). The immediate effect of cardiomyoplasty was the significative reduction in the contractility. However, at 8 or 12 months of follow-up, the LVEF increased in the 72% of the survivors. The end-diastolic volume and the regurgitation index decreased significantly. The clinical status improved in the 81% of the survivors. The best results were obtained in those patients in which a pulse train stimulation was employed in the training phase. Nevertheless, the changes in LVEF are not consistent with the improvement in the clinical status. The improve in the cardiac performance should be also due to the reduction in the left ventricular diameters and in the mitral functional regurgitation.
Fránquiz García
J M
JM
Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba.
Cabrera Alonso
C
C
Dorticós Balea
F
F
Cortada
N
N
Taín Blázquez
J
J
Ramírez López
M
M
Hidalgo Díaz
J
J
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D003462:Cuba; D005260:Female; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging / Q000379:methods; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000637:transplantation*; D011184:Postoperative Period; D011379:Prognosis
Valor de la ventriculografía isotópica en el pronóstico y seguimiento de los pacientes sometidos a miocardioplastia dinámica.