Radionuclide study of mid-term left ventricular function after endoventricular circular patch plasty.
OBJECTIVE
Although the early result of endoventricular circular patch plasty (EVCPP) has been reported, few are seen about the long-term results. We studied left ventricular (LV) function in the early and mid-term periods after EVCPP with electrocardiographic-gated single photon emission computed tomography (Gated SPECT).


METHODS
Consecutive 14 patients with LV asynergy after myocardial infarction, who had the EVCPP procedure, were studied by Gated SPECT. Mean age of patients was 67+/-10 years. Gated SPECT images were obtained and LV end-diastolic volume index (EDVI), LV end-systolic volume index (ESVI) and ejection fraction (EF) were studied with QGS(+) program. Gated SPECT study was performed before surgery, early (23 days) and mid-term periods (32 months) after surgery.


RESULTS
EDVI changed significantly from preoperative value to early postoperative value (107+/-39 to 72+/-37 ml/m(2), P < 0.01). There was no significant difference between early and mid-term postoperative values. ESVI also changed significantly from preoperative value to early postoperative value, and from early value to mid-term postoperative value (78+/-37 to 51+/-34 to 47+/-35 ml/m(2), P < 0.05, respectively). EF increased significantly from preoperative value to early postoperative value, and from early value to mid-term postoperative value (30+/-10 to 35+/-13 to 45+/-18%, P < 0.05, respectively).


CONCLUSIONS
Direct influence of EVCPP brought significant improvement of LV function in early period. Further decrease of ESVI and increase of EF were noticed from early period to mid-term period. This result suggest that the effect of EVCPP sustains long and yields reverse LV remodeling.
Fujii
Hiromichi
H
Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Shinbo 2-228, Fukui city 910-0833, Japan. h_fujii@bellland.or.jp
Ohashi
Hirokazu
H
Tsutsumi
Yasushi
Y
Kawai
Takahiro
T
Iino
Kenji
K
Onaka
Masateru
M
D000368:Aged; D002315:Cardiopulmonary Bypass; D004699:Endocardium / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery; D010496:Pericardium / Q000637:transplantation*; D011184:Postoperative Period; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D016277:Ventricular Function, Left