Ventricular energetics in endoventricular circular patch plasty for dyskinetic XXXX .

@entity1 @entity64 @entity939 @entity67 @entity1002
BACKGROUND: The endoventricular circular patch plasty (Dor procedure) applies to @entity1 with a left @entity67 due to an ischemic dilated ventricle. In the present study, we analyzed left ventricular energetics in @entity1 who underwent the Dor procedure. METHODS: We measured left ventricular contractility (end-systolic elastance; Ees), afterload (effective arterial elastance; Ea), and efficiency (ventriculoarterial coupling; Ea/Ees, and the ratio of @entity64 work and pressure-volume area; SW/ @entity939 ) based on the cardiac catheterization data before and after the Dor procedure in 8 @entity1 with a postinfarction dyskinetic @entity1002 . Concomitant procedures included coronary artery bypass grafting in all @entity1 , mitral valve repair in one @entity1 , and cryoablation in one @entity1 . End-systolic elastance (Ees) and Ea were approximated as follows: Ees = mean arterial pressure/minimal left ventricular volume, and Ea = maximal left ventricular pressure/(maximal left ventricular volume-minimal left ventricular volume), and thereafter Ea/Ees and SW/ @entity939 were calculated. The left ventricular volume was normalized with the body surface area. RESULTS: End-systolic elastance (Ees) increased after the Dor procedure (from 1.15 +/- 0.60 to 1.86 +/- 0.84 mm Hg x m2 x mL(-1), p < 0.01), thus resulting in an improvement in Ea/Ees and SW/ @entity939 (from 2.94 +/- 1.11 to 1.64 +/- 0.49, p < 0.01, and from 0.426 +/- 0.110 to 0.559 +/- 0.082, p < 0.01, respectively), even though Ea did not substantially change (from 2.96 +/- 0.78 to 2.74 +/- 0.55 mm Hg x m2 x mL(-1), p = 0.4). CONCLUSIONS: Left ventricular contractility and efficiency improves after the Dor procedure in @entity1 with a dyskinetic @entity1002 . However, afterload does not change. The use of appropriate afterload-reducing therapy thus plays an especially important role in the management of @entity1 who undergo the Dor procedure.
