title: One-year results after implantation of the CorCap for dilated cardiomyopathy and heart failure.
abstract: BACKGROUND
  We conducted a prospective study of the clinical outcomes and health-related quality of life after implantation of the CorCap support device (Acorn Cardiovascular Inc, St Paul, MN) for dilated cardiomyopathy.
  
  
  METHODS
  The criteria adopted for CorCap implantation were dilated cardiomyopathy (left ventricular [LV] end-diastolic diameter≥60 mm, LV ejection fraction≤0.30 and >0.10), and New York Heart Association functional class II or III despite maximal medical therapy. Echocardiographic follow-up and evaluation with the Short Form-36 questionnaire were performed.
  
  
  RESULTS
  Included were 39 patients: 5 in New York Heart Association class II and 32 in class III. At 13.3±2.5 months of follow-up, a statistically significant improvement was evident in mean LV volume (LV end-systolic volume from 202±94 to 138±72 ml. p=0.005) and systolic function (LV ejection fraction from 0.26±0.05 to 0.36±0.05, p<0.001). The mean LV sphericity index was significantly increased at the end of the follow-up (p=0.009). Ischemic etiology, diabetes, advanced age, and LV ejection fraction of less than 0.15 predicted lesser reversal of the LV alterations. Operative mortality was 5.1%. Cumulative follow-up mortality was 10.2%. The average Physical Health domain scores (Physical Functioning, Role Physical, General Health) were improved. Average Mental Health domain scores were also increased.
  
  
  CONCLUSIONS
  The cardiac support device obtains reverse remodelling of the LV and is useful to improve the quality of life of patients with dilated cardiomyopathy and New York Heart Association class III symptoms of heart failure. The integration of different and complementary strategies (cardiac support device and resynchronization therapy) may represent the key to success for more complex patients, although further studies are required.
authors.affiliation: Department of Cardiac Surgery, Anthea Hospital-GVM Care and Research, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Speziale
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nasso
authors.forename: Felice
authors.initials: F
authors.lastname: Piancone
authors.forename: Katerina
authors.initials: K
authors.lastname: Generali
authors.forename: Carlo
authors.initials: C
authors.lastname: Paterno
authors.forename: Annabella
authors.initials: A
authors.lastname: Miccoli
authors.forename: Flavio
authors.initials: F
authors.lastname: Fiore
authors.forename: Armando
authors.initials: A
authors.lastname: Del Prete
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Prete
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lopriore
authors.forename: Francesco
authors.initials: F
authors.lastname: Spirito
authors.forename: Pasquale
authors.initials: P
authors.lastname: Caldarola
authors.forename: Domenico
authors.initials: D
authors.lastname: Paparella
authors.forename: Francesco
authors.initials: F
authors.lastname: Massari
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology / Q000601:surgery*; D015331:Cohort Studies; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006353:Heart-Assist Devices / Q000523:psychology*; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology