Surgical Ventricular Restoration Improves the Left Ventricle Basal Wall Function Using Quantitative Gated Spect
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概要
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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).Patients and Method: 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.Conclusion: 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.
- Annals of Thoracic and Cardiovascular Surgery 編集委員会の論文
- 2011-12-01
著者
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MATSUI Yoshiro
Department of Cardiovascular Surgery, Hokkaido University Hospital
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Matsui Yoshiro
北海道大学病院 循環器外科
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Kubota Suguru
Department Of Cardiovascular Surgery Hokkaido University Hospital
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Sasaki Shigeyuki
愛心メモリアル病院 心臓血管外科
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Suto Yukio
Department Of Cardiovascular Surgery Ikegami General Hospital Heart Center
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Yoshinaga Keiichiro
Department Of Cardiology Kagoshima City Medical Association Hospital
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Wakasa Satoru
Department Of Cardiovascular Surgery Hokkaido University School Of Medicine
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Matsui Yoshiro
Department Of Cardiac Surgery Hokkaido University Hospital
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Sasaki Shigeyuki
Division Of Medical Science Health Sciences University Of Hokkaido
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Wakasa Satoru
Department Of Cardiovascular Surgery Hokkaido University Hospital
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Matsui Yoshiro
Department Of Cardiovascular Surgery Hokkaido University Postgraduate School Of Medicine
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Matsuzaki Kenji
Department Of Cardiovascular Surgery Hokkaido University Hospital
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Suto Yukio
Department Of Cardiovascular Surgery Ikegami General Hospital
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MATSUI Kinya
Department of Cardiovascular Surgery, Hokkaido University Hospital
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Wakasa Satoru
Department Of Cardiovascular And Thoracic Surgery Graduate School Of Medicine Hokkaido University
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Matsui Kinya
Department Of Cardiovascular Surgery Hokkaido University Hospital
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Yoshinaga Keiichiro
Department Of Nuclear Medicine Hokkaido University Graduate School Of Medicine
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