Effects of surgical ventricular reconstruction and mitral complex reconstruction on cardiac oxidative metabolism and efficiency in nonischemic and ischemic dilated cardiomyopathy

Takashi Sugiki, Masanao Naya, Osamu Manabe, Satoru Wakasa, Suguru Kubota, Satoru Chiba, Hiroyuki Iwano, Satoshi Yamada, Keiichiro Yoshinaga, Nagara Tamaki, Hiroyuki Tsutsui, Yoshiro Matsui

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: The aim of this study was to investigate the effects of surgical ventricular reconstruction (SVR) on cardiac efficiency as a surrogate marker for cardiac function and oxidative metabolism in patients with severe heart failure. Background: Our new integrated overlapping left ventriculoplasty, modified SVR, combined with mitral complex reconstruction, reduce left ventricular (LV) volume associated with improvement of symptoms of heart failure. Methods: Twelve consecutive patients with end-stage heart failure due to nonischemic dilated cardiomyopathy (DCM) (n = 6) and ischemic dilated cardiomyopathy (ICM) (n = 6) who underwent SVR were studied. Myocardial oxidative metabolism per gram of tissue was estimated by monoexponential clearance of 11C-acetate positron emission tomography (K mono). Forward stroke volume at the LV outflow tract was measured by echocardiography. Cardiac efficiency was estimated by the ratio of external work (stroke volume at the LV outflow tract index × systolic blood pressure × heart rate) to K mono before and 1 month after SVR. Results: After SVR, medians of New York Heart Association functional class significantly improved from 3 to 1.5 (p < 0.01) in both DCM and ICM patients. End-systolic and end-diastolic volume and LV mass significantly decreased in both groups. Stroke volume at the LV outflow tract increased from 43 ± 8 ml to 52 ± 11 ml (p = 0.028) in DCM patients, but not in ICM patients (49 ± 21 ml to 59 ± 26 ml, p = 0.12). K mono × LV mass, as an index of global LV oxidative metabolism, decreased in DCM patients (13.6 ± 1.9 g/min vs. 8.6 ± 1.5 g/min, p = 0.03) and ICM patients (12.0 ± 3.4 g/min vs. 9.2 ± 1.0 g/min, p = 0.06). As a result, cardiac efficiency increased in all patients with DCM (3.34 ± 0.46 × 10E6 vs. 4.74 ± 0.88 × 10E6 mm Hg·ml·min/m 2, p = 0.03) and in 5 of 6 patients with ICM (4.54 ± 1.66 × 10E6 vs. 5.99 ± 2.11 × 10E6 mm Hg·ml·min/m 2, p = 0.12). Conclusions: Combined surgery with SVR and mitral complex reconstruction reduced LV volume in association with improvement of cardiac efficiency in patients with severe heart failure.

Original languageEnglish
Pages (from-to)762-770
Number of pages9
JournalJACC: Cardiovascular Imaging
Volume4
Issue number7
DOIs
Publication statusPublished - Jul 1 2011

Fingerprint

Dilated Cardiomyopathy
Stroke Volume
Heart Failure
Blood Pressure
Positron-Emission Tomography
Echocardiography
Biomarkers
Heart Rate

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of surgical ventricular reconstruction and mitral complex reconstruction on cardiac oxidative metabolism and efficiency in nonischemic and ischemic dilated cardiomyopathy. / Sugiki, Takashi; Naya, Masanao; Manabe, Osamu; Wakasa, Satoru; Kubota, Suguru; Chiba, Satoru; Iwano, Hiroyuki; Yamada, Satoshi; Yoshinaga, Keiichiro; Tamaki, Nagara; Tsutsui, Hiroyuki; Matsui, Yoshiro.

In: JACC: Cardiovascular Imaging, Vol. 4, No. 7, 01.07.2011, p. 762-770.

Research output: Contribution to journalArticle

Sugiki, Takashi ; Naya, Masanao ; Manabe, Osamu ; Wakasa, Satoru ; Kubota, Suguru ; Chiba, Satoru ; Iwano, Hiroyuki ; Yamada, Satoshi ; Yoshinaga, Keiichiro ; Tamaki, Nagara ; Tsutsui, Hiroyuki ; Matsui, Yoshiro. / Effects of surgical ventricular reconstruction and mitral complex reconstruction on cardiac oxidative metabolism and efficiency in nonischemic and ischemic dilated cardiomyopathy. In: JACC: Cardiovascular Imaging. 2011 ; Vol. 4, No. 7. pp. 762-770.
@article{a95d0b3d167b41bb9263943152adcccc,
title = "Effects of surgical ventricular reconstruction and mitral complex reconstruction on cardiac oxidative metabolism and efficiency in nonischemic and ischemic dilated cardiomyopathy",
abstract = "Objectives: The aim of this study was to investigate the effects of surgical ventricular reconstruction (SVR) on cardiac efficiency as a surrogate marker for cardiac function and oxidative metabolism in patients with severe heart failure. Background: Our new integrated overlapping left ventriculoplasty, modified SVR, combined with mitral complex reconstruction, reduce left ventricular (LV) volume associated with improvement of symptoms of heart failure. Methods: Twelve consecutive patients with end-stage heart failure due to nonischemic dilated cardiomyopathy (DCM) (n = 6) and ischemic dilated cardiomyopathy (ICM) (n = 6) who underwent SVR were studied. Myocardial oxidative metabolism per gram of tissue was estimated by monoexponential clearance of 11C-acetate positron emission tomography (K mono). Forward stroke volume at the LV outflow tract was measured by echocardiography. Cardiac efficiency was estimated by the ratio of external work (stroke volume at the LV outflow tract index × systolic blood pressure × heart rate) to K mono before and 1 month after SVR. Results: After SVR, medians of New York Heart Association functional class significantly improved from 3 to 1.5 (p < 0.01) in both DCM and ICM patients. End-systolic and end-diastolic volume and LV mass significantly decreased in both groups. Stroke volume at the LV outflow tract increased from 43 ± 8 ml to 52 ± 11 ml (p = 0.028) in DCM patients, but not in ICM patients (49 ± 21 ml to 59 ± 26 ml, p = 0.12). K mono × LV mass, as an index of global LV oxidative metabolism, decreased in DCM patients (13.6 ± 1.9 g/min vs. 8.6 ± 1.5 g/min, p = 0.03) and ICM patients (12.0 ± 3.4 g/min vs. 9.2 ± 1.0 g/min, p = 0.06). As a result, cardiac efficiency increased in all patients with DCM (3.34 ± 0.46 × 10E6 vs. 4.74 ± 0.88 × 10E6 mm Hg·ml·min/m 2, p = 0.03) and in 5 of 6 patients with ICM (4.54 ± 1.66 × 10E6 vs. 5.99 ± 2.11 × 10E6 mm Hg·ml·min/m 2, p = 0.12). Conclusions: Combined surgery with SVR and mitral complex reconstruction reduced LV volume in association with improvement of cardiac efficiency in patients with severe heart failure.",
author = "Takashi Sugiki and Masanao Naya and Osamu Manabe and Satoru Wakasa and Suguru Kubota and Satoru Chiba and Hiroyuki Iwano and Satoshi Yamada and Keiichiro Yoshinaga and Nagara Tamaki and Hiroyuki Tsutsui and Yoshiro Matsui",
year = "2011",
month = "7",
day = "1",
doi = "10.1016/j.jcmg.2011.04.010",
language = "English",
volume = "4",
pages = "762--770",
journal = "JACC: Cardiovascular Imaging",
issn = "1936-878X",
publisher = "Elsevier Inc.",
number = "7",

}

TY - JOUR

T1 - Effects of surgical ventricular reconstruction and mitral complex reconstruction on cardiac oxidative metabolism and efficiency in nonischemic and ischemic dilated cardiomyopathy

AU - Sugiki, Takashi

AU - Naya, Masanao

AU - Manabe, Osamu

AU - Wakasa, Satoru

AU - Kubota, Suguru

AU - Chiba, Satoru

AU - Iwano, Hiroyuki

AU - Yamada, Satoshi

AU - Yoshinaga, Keiichiro

AU - Tamaki, Nagara

AU - Tsutsui, Hiroyuki

AU - Matsui, Yoshiro

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Objectives: The aim of this study was to investigate the effects of surgical ventricular reconstruction (SVR) on cardiac efficiency as a surrogate marker for cardiac function and oxidative metabolism in patients with severe heart failure. Background: Our new integrated overlapping left ventriculoplasty, modified SVR, combined with mitral complex reconstruction, reduce left ventricular (LV) volume associated with improvement of symptoms of heart failure. Methods: Twelve consecutive patients with end-stage heart failure due to nonischemic dilated cardiomyopathy (DCM) (n = 6) and ischemic dilated cardiomyopathy (ICM) (n = 6) who underwent SVR were studied. Myocardial oxidative metabolism per gram of tissue was estimated by monoexponential clearance of 11C-acetate positron emission tomography (K mono). Forward stroke volume at the LV outflow tract was measured by echocardiography. Cardiac efficiency was estimated by the ratio of external work (stroke volume at the LV outflow tract index × systolic blood pressure × heart rate) to K mono before and 1 month after SVR. Results: After SVR, medians of New York Heart Association functional class significantly improved from 3 to 1.5 (p < 0.01) in both DCM and ICM patients. End-systolic and end-diastolic volume and LV mass significantly decreased in both groups. Stroke volume at the LV outflow tract increased from 43 ± 8 ml to 52 ± 11 ml (p = 0.028) in DCM patients, but not in ICM patients (49 ± 21 ml to 59 ± 26 ml, p = 0.12). K mono × LV mass, as an index of global LV oxidative metabolism, decreased in DCM patients (13.6 ± 1.9 g/min vs. 8.6 ± 1.5 g/min, p = 0.03) and ICM patients (12.0 ± 3.4 g/min vs. 9.2 ± 1.0 g/min, p = 0.06). As a result, cardiac efficiency increased in all patients with DCM (3.34 ± 0.46 × 10E6 vs. 4.74 ± 0.88 × 10E6 mm Hg·ml·min/m 2, p = 0.03) and in 5 of 6 patients with ICM (4.54 ± 1.66 × 10E6 vs. 5.99 ± 2.11 × 10E6 mm Hg·ml·min/m 2, p = 0.12). Conclusions: Combined surgery with SVR and mitral complex reconstruction reduced LV volume in association with improvement of cardiac efficiency in patients with severe heart failure.

AB - Objectives: The aim of this study was to investigate the effects of surgical ventricular reconstruction (SVR) on cardiac efficiency as a surrogate marker for cardiac function and oxidative metabolism in patients with severe heart failure. Background: Our new integrated overlapping left ventriculoplasty, modified SVR, combined with mitral complex reconstruction, reduce left ventricular (LV) volume associated with improvement of symptoms of heart failure. Methods: Twelve consecutive patients with end-stage heart failure due to nonischemic dilated cardiomyopathy (DCM) (n = 6) and ischemic dilated cardiomyopathy (ICM) (n = 6) who underwent SVR were studied. Myocardial oxidative metabolism per gram of tissue was estimated by monoexponential clearance of 11C-acetate positron emission tomography (K mono). Forward stroke volume at the LV outflow tract was measured by echocardiography. Cardiac efficiency was estimated by the ratio of external work (stroke volume at the LV outflow tract index × systolic blood pressure × heart rate) to K mono before and 1 month after SVR. Results: After SVR, medians of New York Heart Association functional class significantly improved from 3 to 1.5 (p < 0.01) in both DCM and ICM patients. End-systolic and end-diastolic volume and LV mass significantly decreased in both groups. Stroke volume at the LV outflow tract increased from 43 ± 8 ml to 52 ± 11 ml (p = 0.028) in DCM patients, but not in ICM patients (49 ± 21 ml to 59 ± 26 ml, p = 0.12). K mono × LV mass, as an index of global LV oxidative metabolism, decreased in DCM patients (13.6 ± 1.9 g/min vs. 8.6 ± 1.5 g/min, p = 0.03) and ICM patients (12.0 ± 3.4 g/min vs. 9.2 ± 1.0 g/min, p = 0.06). As a result, cardiac efficiency increased in all patients with DCM (3.34 ± 0.46 × 10E6 vs. 4.74 ± 0.88 × 10E6 mm Hg·ml·min/m 2, p = 0.03) and in 5 of 6 patients with ICM (4.54 ± 1.66 × 10E6 vs. 5.99 ± 2.11 × 10E6 mm Hg·ml·min/m 2, p = 0.12). Conclusions: Combined surgery with SVR and mitral complex reconstruction reduced LV volume in association with improvement of cardiac efficiency in patients with severe heart failure.

UR - http://www.scopus.com/inward/record.url?scp=79960311081&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960311081&partnerID=8YFLogxK

U2 - 10.1016/j.jcmg.2011.04.010

DO - 10.1016/j.jcmg.2011.04.010

M3 - Article

C2 - 21757167

AN - SCOPUS:79960311081

VL - 4

SP - 762

EP - 770

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

SN - 1936-878X

IS - 7

ER -