title: Surgical ventricular restoration improves the left ventricle basal wall function using quantitative gated SPECT.
abstract: OBJECTIVE
  It is not clear whether surgical ventricular restoration (SVR) or procedures approaching mitral complex for controlling functional mitral regurgitation (MR) affect the regional left ventricular wall function. The purpose of the present study was to evaluate the regional LV function after SVR using overlapping left ventriculoplasty (OLVP) using quantitative gated myocardial perfusion SPECT (QGS).
  
  
  METHODS
  Forty-one heart failure patients, including those with ischemic cardiomyopathy (ICM) (n = 25) and non-ICM (NICM) (n = 16), underwent SVR and/or papillary muscle approximation (PMA). The rest myocardial perfusion SPECT were performed before and early after operation (mean 25.8 ± 10.6 days). These patients were divided into 4 groups based on the surgical procedures (SVR and/or PMA) and etiology of patients (ICM or NICM) as follows: SVR (with or without PMA) of ICM, SVR of NICM, PMA of ICM and PMA of NICM groups. The regional wall thickening was compared before and after the operation between the four groups.
  
  
  RESULTS
  NYHA functional classes were improved after the operation in all four groups. MR grade was also improved in three groups other than SVR of the ICM group. The left ventricular basal wall thickening was improved postoperatively in following three groups (SVR of ICM: 12.7 ± 3.8% to 16.5 ± 4.6% p <0.05, PMA of ICM: 11.1 ± 4.3% to 14.9 ± 4.8% p <0.05, SVR of NICM: 5.8 ± 6.6% to 12.3 ± 6.4% p <0.05), whereas PMA of the NICM group did not show an improvement. Wall thickening in the middle and distal levels was not improved in all groups.
  
  
  CONCLUSIONS
  OLVP improved NYHA functional classes, and also improved the regional wall function at the basal level of the left ventricle. In contrast, lone PMA did not improve or impair the regional wall function at any of the levels.
authors: Department of Cardiovascular Surgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. suguru-k@med.hokudai.ac.jp
authors: Suguru
authors: S
authors: Kubota
authors: Kinya
authors: K
authors: Matsui
authors: Satoru
authors: S
authors: Wakasa
authors: Yukio
authors: Y
authors: Suto
authors: Shigeyuki
authors: S
authors: Sasaki
authors: Keiichiro
authors: K
authors: Yoshinaga
authors: Yoshiro
authors: Y
authors: Matsui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D003326:Coronary Circulation; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left