The Carpentier-Edwards Classic and Physio Mitral Annuloplasty Rings: A Randomized Trial

2006 ◽  
Vol 8 (5) ◽  
pp. 389 ◽  
Author(s):  
Ghada M. M. Shahin ◽  
Geert J. M. G. van der Heijden ◽  
Michiel L. Bots ◽  
Maarten-Jan Cramer ◽  
Wybren Jaarsma ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Nyha Class ◽  
Left Ventricular ◽  
Mitral Annuloplasty ◽  
Risk Of Death ◽  
Late Failure

<P>Objective: To evaluate clinical and echocardiographic outcomes for the semi-flexible Carpentier-Edwards Physio and the rigid Classic mitral annuloplasty ring. </P><P>Methods: Ninety-six patients were randomized for either a Classic (n = 53) or a Physio (n = 43) ring from October 1995 through July 1997. Mean follow-up was 5.1 years (range .1-6.6). We included standard patient characteristics at baseline and during follow-up. Analyses were adjusted for age and gender, and for factors that differed across groups at baseline. In 2002, echocardiography was performed in 74% of the survivors. </P><P>Results: We found a 16% difference in mortality: 14% in the Physio group (n = 6) and 30% in the Classic group (n = 16) (adjusted P = .41). Life table analysis shows that the absolute risk of death after 30 months is lower in the Physio group. Intra-operative repair failure occurred in 3 patients (6%) of the Classic group, and in 4 (9%) of the Physio group, resulting in mitral valve replacement. Late failure occurred in 1 patient (2%) in the Classic group, and in 4 (9%) in the Physio group. At follow-up, left ventricular function did not differ across groups (ejection fraction 45% and 48% (adjusted P = .65)). The combined NYHA class III-IV had improved for the Classic group in 42% and for the Physio group in 34%. </P><P>Conclusion: Although the 16% difference in mortality did not reach statistical significance, it is considered clinically important. No differences in morbidity, valve function, and left ventricular function were found. Further research to explain the difference in mortality is required.</P>

P5545Predictors of 10-year mortality and re-intervention in patients with multivessel coronary disease, reduced systolic left ventricular function, after complete revascularization by PCI or CABG

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Popov ◽  
J Dejanovic ◽  
M Petrovic ◽  
I Srdanovic ◽  
S Tadic ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Coronary Disease ◽  
Systolic Function ◽  
Nyha Class ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Complete Revascularization ◽  
Systolic Left Ventricular Function

Abstract Introduction In patients with multivessel coronary disease, the decision on revascularization should be made through a heart team. Whether there is an optimal method and what are the predictors of mortality and repeated interventions is the subject of numerous studies. Purpose To determine what are the predictors of 10-year mortality and repeated interventions in patients with multivessel coronary disease and reduced systolic left ventricular function in which complete revascularization is done through percutaneous coronary intervention (PCI) and surgical aortocoronary bypass (CABG). Methods The survey included 178 patients who underwent elective revascularization of multivessel coronary disease in one center during 2008 through PCI or bypass, according to the heart team's decision. All subjects had a reduced left ventricular systolic function, ejection fraction less than 50%. The study excluded patients with acute coronary syndrome. The basic demographic and clinical characteristics of the subjects and risk factors were analyzed. Results Ten-year mortality was 31.4%, without a significant difference between the examined groups (in the PCI group 25 patients (30.5%) in the bypass group 30 (32.3%), p>0.05). In subjects with letal outcome during 10-year follow-up, lower hemoglobin levels in discharge, enlarged cardiac cavities, increased internal diameter of left ventricle in systole (LVIDs) and enlarged left atrium, lower systolic left ventricular function, higher EUROscore and higher NYHA class in discharge. The enlarged left ventricular diameter in systole (OR 2.28 (1.27–4.11), p=0.006) and the NYHA class (OR 2.49 (1.22–5.08), p=0.012) are independent predictors ten-year mortality. In the group of patients undergoing surgical revascularization, independent predictors of 10-year mortality are higher levels of uric acid (OR 1,006 (1,000–1,011), P=0,047) and lower serum hemoglobin at discharge (OR 0,959 (0,919–0,999), P=0.046), while in PCI group LVIDs (OR 2.89 (1.351–6.196), p=0.006). During the 10-year follow-up, repeated PCI was performed in 12 (14.5%) patients in the PCI group and in 3 (3.2%) patients in the CABG group, p=0.012. No surgical revascularization was performed during follow up. Diabetes mellitus is an independent predictor of reintervention in the PCI group (OR 4.12 (1.153–14.703), p=0.029). Conclusion Mortality predictors during ten years of follow-up in subjects following a revascularization of multivessel coronary disease, and with reduced left ventricular systolic function, are increased systolic left ventricular diameter and higher NYHA class in discharge. Reintervention is more commonly performed after PCI and the presence of diabetes mellitus is an independent predictor.

scholarly journals COMPARISON OF EFFECT OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION WITH STREPTOKINASE IN ACUTE ST ELEVATION MYOCARDIAL INFARCTION (STEMI) ON LEFT VENTRICULAR FUNCTION AFTER 3 MONTHS

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S860-64
Author(s):  
Saleha Abbas ◽  
Abdul Hameed Siddiqui ◽  
Ammar Cheema ◽  
Ayesha Abbas ◽  
Sadaf Khan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Primary Percutaneous Coronary Intervention ◽  
Statistical Significance ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Percutaneous Coronary ◽  
St Elevation

Objective: To assess the left ventricular function three months after the primary percutaneous coronary intervention versus Streptokinase in ST elevation myocardial infarction. Study Design: Prospective comparative study. Place and Duration of Study: Cardiac Catheterization Lab, in-patients and out patients departments of Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi from Jun 2018 to Jun 2019. Methodology: Patients included in the study were with first acute MI treated with primary PCI/SK, having systolic blood pressure >90 mmhg, pre-infarction EF >40% and with no previous history of coronary artery bypass grafting or angioplasty. All patients undergoing primary percutaneous coronary intervention/Streptokinase injection were assessed for left ventricular function at day one by transthoracic echocardiography and then three months later by transthoracic echocardiography. Two-dimensional echocardiography was being performed immediately after primary percutaneous coronary intervention on day one and at three months follow-up. Results: There were 80 patients recruited in the study. Mean age of the patients was 55.5 ± 11.6 years with range 36-81 years. Sixty nine (86.3%) patients were male while 11 (13.48%) were female patients. Most common comorbid was smoking 37 (46.3%) followed by diabetes mellitus 25 (31.3%). Most common culprit artery was left anterior descending 38 (47.5%) followed by left circumflex 15 (18.8%) and then right coronary artery 14 (17.5%). Independent sample t-test was applied to find out the statistical significance between two groups (Streptokinase group vs PPCI group). Ejection fraction of the patients was checked at the time of discharge and after three months follow-up and result showed the statistical significance with p-value <0.05. Conclusion: Based on this comparative analysis of improvement of left ventricular function between streptokinase and primary percutaneous coronary intervention, we concluded that after three months satisfactory ejection fraction is seen in patients treated with primary percutaneous coronary intervention as compared to patients treated with streptokinase.

Abstract 18973: Left Ventricular Function Improvement After Recent MI in Patients Using a Wearable Cardioverter Defibrillator

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Chingping Wan ◽  
Steven J Szymkiewicz
Keyword(s):  
Heart Failure ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Clinical Characteristics ◽  
Treated Group ◽  
Left Ventricular ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Wearable Cardioverter Defibrillator

Introduction: The wearable cardioverter defibrillator (WCD) has been used to protect AMI patients with reduced LVEF (≤35%) until ICD evaluation is recommended. The rate of EF improvement (e.g. EF>35%) over the initial 8-12 weeks after AMI has not been reported. METHODS: The manufacturer-maintained registry was searched for AMI patients who received a WCD shock for VT/VF between 05/2008 and 02/2013. The treated group was matched (1: ~4) with event-free WCD patients by ICD-9 code (410.*), gender, age and prescription date. Chart notes were reviewed for clinical characteristics. Follow-up was assessed through the registry and Social Security Death Master File. RESULTS: There were 992 (age=63±12, female=20.2%) AMI patients included in the final analysis, 206 treated by WCD and 786 event-free patients. Median follow-up was 334 days. Mean length of WCD use was 67±506 (median=38) days. Subgroup clinical characteristics are presented in Table 1. In the event-free group, 289 (38.9%) patients showed EF improvement to >35%. Nine (4.5%) in the treated group continued wearing the WCD until EF recovery, while 125 (60.7%) received ICD. Absence of recorded heart failure and/or diabetes were associated with LVEF recovery (p<.0001). CONCLUSION: In our study, almost 40% of AMI patients with initial EF ≤35% had EF improvement in two months. The EF recovery group had lower rates of heart failure and diabetes. WCD allows time for left ventricular function recovery in low EF post MI patients, optimizing ICD implantation decisions.

scholarly journals Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Yao-Dan Liang ◽  
Yuan-Wei Xu ◽  
Wei-Hao Li ◽  
Ke Wan ◽  
Jia-Yu Sun ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
T2 Mapping ◽  
Left Ventricular ◽  
Ventricular Ejection Fraction ◽  
Native T1 ◽  
Function Recovery ◽  
Myocardial T1 ◽  
T1 And T2

Abstract Background Peripartum cardiomyopathy (PPCM) is rare and potentially life-threatening; its etiology remains unclear. Imaging characteristics on cardiovascular magnetic resonance (CMR) and their prognostic significance have rarely been studied. We sought to determine CMR’s prognostic value in PPCM by using T1 and T2 mapping techniques. Methods Data from 21 PPCM patients from our CMR registry database were analyzed. The control group comprised 20 healthy age-matched females. All subjects underwent comprehensive contrast-enhanced CMR. T1 and T2 mapping using modified Look-Locker inversion recovery and T2 prep balanced steady-state free precession sequences, respectively. Ventricular size and function, late gadolinium enhancement (LGE), myocardial T1 value, extracellular volume (ECV), and T2 value were analyzed. Transthoracic echocardiography was performed at baseline and during follow-up. The recovered left ventricular ejection fraction (LVEF) was defined as LVEF ≥50% on echocardiography follow-up after at least 6 months of the diagnosis. Results CMR imaging showed that the PPCM patients had severely impaired LVEF and right ventricular ejection fraction (LVEF: 26.8 ± 10.6%; RVEF: 33.9 ± 14.6%). LGE was seen in eight (38.1%) cases. PPCM patients had significantly higher native T1 and ECV (1345 ± 79 vs. 1212 ± 32 ms, P < 0.001; 33.9 ± 5.2% vs. 27.1 ± 3.1%, P < 0.001; respectively) and higher myocardial T2 value (42.3 ± 3.7 vs. 36.8 ± 2.3 ms, P < 0.001) than did the normal controls. After a median 2.5-year follow-up (range: 8 months-5 years), six patients required readmission for heart failure, two died, and 10 showed left ventricular function recovery. The LVEF-recovered group showed significantly lower ECV (30.7 ± 2.1% vs. 36.8 ± 5.6%, P = 0.005) and T2 (40.6 ± 3.0 vs. 43.9 ± 3.7 ms, P = 0.040) than the unrecovered group. Multivariable logistic regression analysis showed ECV (OR = 0.58 for per 1% increase, P = 0.032) was independently associated with left ventricular recovery in PPCM. Conclusions Compared to normal controls, PPCM patients showed significantly higher native T1, ECV, and T2. Native T1, ECV, and T2 were associated with LVEF recovery in PPCM. Furthermore, ECV could independently predict left ventricular function recovery in PPCM.

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