Original articleAdult cardiacImpact of Surgical Ventricular Restoration on Diastolic Function: Implications of Shape and Residual Ventricular Size
Section snippets
Study Design
This was a retrospective study based on the institutional database of the Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato for patients undergoing SVR. The study design was submitted to the Local Ethics Committee, which waived the need for approval in consideration of the retrospective nature of the study. All the patients admitted to the study gave their informed consent for the scientific analysis of their clinical data in an anonymous form.
Patient
One hundred and forty-six
Results
The preoperative diastolic profile is reported in Table 1. Seven (7) patients (4.8%) showed a normal pattern, 99 patients (68%) an abnormal relaxation pattern, 28 patients (19%) a pattern of pseudonormalization, and 12 patients (8.2%) a restrictive pattern. Factors associated with the degree of diastolic dysfunction were age (abnormal relaxation vs pseudonormalization, p = 0.004), EF (pseudonormalization vs restrictive pattern, p = 0.015), left atrium dimension (abnormal relaxation vs
Comment
The major findings of this study include the following; (1) Diastolic dysfunction occurs in the majority of patients affected by ischemic dilated cardiomyopathy and heart failure suitable for SVR; (2) after surgery, the average DF is impaired even if a worsening of the diastolic pattern occurs in a minority of the patients; (3) the preoperative shape, irrespective of the volumes, is a predictor of DF worsening; and (4) a limited surgical volume reduction associated with a relatively small
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