Evaluation of predictors of clinical outcome after partial left ventriculectomy.
BACKGROUND
Outcome after partial left ventriculectomy (PLV) is difficult to predict. Our goal was to determine if clinical measurements including exercise testing could predict outcome after PLV.


METHODS
Sixteen patients with dilated cardiomyopathy had left ventricular ejection fraction, left ventricular end-diastolic diameter, amount of mitral regurgitation (MR), New York Heart Association (NYHA) functional class, and cardiopulmonary exercise testing measurements measured before PLV and 3 months after PLV. Eleven patients who remained stable after PLV (group 1) were compared with 5 patients who deteriorated after PLV (group 2).


RESULTS
Similar significant improvements were seen in both groups 3 months post-PLV with respect to left ventricular ejection fraction (group 1: 0.136+/-0.037 to 0.212+/-0.046; group 2: 0.139+/-0.042 to 0.179+/-0.073) and left ventricular end-diastolic diameter (group 1: 8.5+/-0.7 to 7.0+/-0.6 cm; group 2: 7.6+/-0.6 to 6.5+/-0.6 cm). The MR grade (1.0+/-0.6 versus 2.5+/-0.6), NYHA functional class (1.5+/-0.31 versus 2.5+/-0.6), and peak oxygen consumption (17.8+/-1.1 versus 12.2+/-2.0) were significantly different in the two groups 3 months after PLV (p < 0.05, analysis of variance).


CONCLUSIONS
Patients that do not show significant improvement in peak oxygen consumption, NYHA class and significant decrease in the amount of MR 3 months after PLV, compared with pre-PLV, are at increased risk of clinically deteriorating.
Bhat
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Department of Medicine, University of Louisville, Kentucky, USA. g0bhat01@gwise.louisville.edu
Dowling
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D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left / Q000502:physiology