Left atrial function and work after surgical ventricular restoration in postmyocardial infarction heart failure.
BACKGROUND
The purpose of the current study was to examine the effect of surgical ventricular restoration in left atrial (LA) performance and left ventricular (LV) diastolic function in patients with congestive heart failure after extensive anterior myocardial infarction.


METHODS
Seventeen consecutive patients (age 63 +/- 9 years, 14 male, 4 with diabetes) were studied prospectively. All patients underwent surgical ventricular restoration and concomitant coronary artery bypass surgery. LA volumes were calculated, as were peak LA kinetic energy (LAKE) and LA ejection fraction (LAEF). LV diastolic filling patterns were also assessed.


RESULTS
Follow-up period was 1 year. LA size and volumes did not change significantly during the follow-up period. Two distinct groups of patients were identified: group A, in which LAEF and peak LAKE increased, and group B, in which LAEF and peak LAKE decreased. In both groups, the LAEF and peak LAKE appeared to increase or decrease simultaneously and this became evident from the first month after the surgery. However, 1 year after the operation, diastolic filling pattern was significantly different between the two groups. LA function showed improvement only in patients who demonstrated an improvement in indices of diastolic filling pattern.


CONCLUSIONS
Despite improvement in clinical status and indices of LV systolic function in all patients who underwent surgical ventricular restoration for treatment of congestive heart failure as a result of LV dilatation secondary to large myocardial infarction, improvement of LA function occurs in patients with improved LV diastolic function.
Dardas
Petros S
PS
Department of Cardiology and Cardiothoracic Surgery, Thessaloniki Heart Institute, St Luke Hospital, Thessaloniki, Greece.
Pitsis
Antonis A
AA
Mezilis
Nikos E
NE
Tsikaderis
Dimitris D
DD
Ninios
Vlasis N
VN
Boudoulas
Harisios
H
D016279:Atrial Function, Left / Q000502:physiology*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003971:Diastole; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D011184:Postoperative Period; D011379:Prognosis; D012720:Severity of Illness Index; D016277:Ventricular Function, Left / Q000502:physiology