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Article: Surgical ventricular restoration for patients with ischemic heart failure: Determinants of two-year survival

TitleSurgical ventricular restoration for patients with ischemic heart failure: Determinants of two-year survival
Authors
Issue Date2011
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
Citation
Annals Of Thoracic Surgery, 2011, v. 91 n. 2, p. 491-498 How to Cite?
AbstractBackground Surgical ventricular restoration (SVR) improves left ventricular (LV) systolic function by partially restoring the normal geometry of the left ventricle. However, the beneficial effects of this surgical procedure on long-term clinical outcome remain controversial. The present study aimed to evaluate the independent determinants of 2-year morbidity and mortality rates after SVR. Methods Seventy-nine patients with ischemic heart disease and LV ejection fraction of 0.35 or less were included. All patients underwent SVR and additionally coronary artery bypass grafting or mitral valve surgery if clinically indicated. Clinical and echocardiographic examination was performed before SVR and at 6 months' follow-up. The primary end point was a composite of all-cause mortality and hospitalizations for heart failure. Results At 6 months' follow-up a significant improvement in heart failure symptoms was noted. In addition, LV ejection fraction increased from 0.27 ± 0.07 to 0.36 ± 0.10 (p < 0.001). During a median follow-up of 2.7 years, the primary end point was recorded in 22% of the patients. Baseline New York Heart Association functional class IV and a 6-month follow-up LV end-systolic volume index of at least 60 mL/m 2 were independently associated with worse outcome (hazard ratio, 5.4; 95% confidence interval, 1.9 to 15.2; p < 0.001; hazard ratio, 2.7; 95% confidence interval, 1.3 to 5.6; p < 0.001, respectively). Conclusions Advanced heart failure status at baseline and large residual postsurgery LV end-systolic volume index were independently associated with increased mortality and heart failure hospitalization rates at 2 years' follow-up after SVR. © 2011 The Society of Thoracic Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/163357
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWitkowski, TGen_US
dc.contributor.authorTen Brinke, EAen_US
dc.contributor.authorDelgado, Ven_US
dc.contributor.authorNg, ACTen_US
dc.contributor.authorBertini, Men_US
dc.contributor.authorMarsan, NAen_US
dc.contributor.authorEwe, SHen_US
dc.contributor.authorAuger, Den_US
dc.contributor.authorYiu, KHen_US
dc.contributor.authorBraun, Jen_US
dc.contributor.authorKlein, Pen_US
dc.contributor.authorSteendijk, Pen_US
dc.contributor.authorVersteegh, MIMen_US
dc.contributor.authorKlautz, RJen_US
dc.contributor.authorBax, JJen_US
dc.date.accessioned2012-09-05T05:30:29Z-
dc.date.available2012-09-05T05:30:29Z-
dc.date.issued2011en_US
dc.identifier.citationAnnals Of Thoracic Surgery, 2011, v. 91 n. 2, p. 491-498en_US
dc.identifier.issn0003-4975en_US
dc.identifier.urihttp://hdl.handle.net/10722/163357-
dc.description.abstractBackground Surgical ventricular restoration (SVR) improves left ventricular (LV) systolic function by partially restoring the normal geometry of the left ventricle. However, the beneficial effects of this surgical procedure on long-term clinical outcome remain controversial. The present study aimed to evaluate the independent determinants of 2-year morbidity and mortality rates after SVR. Methods Seventy-nine patients with ischemic heart disease and LV ejection fraction of 0.35 or less were included. All patients underwent SVR and additionally coronary artery bypass grafting or mitral valve surgery if clinically indicated. Clinical and echocardiographic examination was performed before SVR and at 6 months' follow-up. The primary end point was a composite of all-cause mortality and hospitalizations for heart failure. Results At 6 months' follow-up a significant improvement in heart failure symptoms was noted. In addition, LV ejection fraction increased from 0.27 ± 0.07 to 0.36 ± 0.10 (p < 0.001). During a median follow-up of 2.7 years, the primary end point was recorded in 22% of the patients. Baseline New York Heart Association functional class IV and a 6-month follow-up LV end-systolic volume index of at least 60 mL/m 2 were independently associated with worse outcome (hazard ratio, 5.4; 95% confidence interval, 1.9 to 15.2; p < 0.001; hazard ratio, 2.7; 95% confidence interval, 1.3 to 5.6; p < 0.001, respectively). Conclusions Advanced heart failure status at baseline and large residual postsurgery LV end-systolic volume index were independently associated with increased mortality and heart failure hospitalization rates at 2 years' follow-up after SVR. © 2011 The Society of Thoracic Surgeons.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsuren_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.subject.meshCause Of Deathen_US
dc.subject.meshComorbidityen_US
dc.subject.meshConfidence Intervalsen_US
dc.subject.meshDiabetes Mellitus - Epidemiologyen_US
dc.subject.meshEchocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeart Failure - Mortality - Surgery - Ultrasonographyen_US
dc.subject.meshHeart Ventricles - Surgery - Ultrasonographyen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertension - Epidemiologyen_US
dc.subject.meshLength Of Stayen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Ischemia - Mortality - Ultrasonographyen_US
dc.subject.meshPulmonary Disease, Chronic Obstructive - Epidemiologyen_US
dc.subject.meshStroke Volumeen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshSystoleen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleSurgical ventricular restoration for patients with ischemic heart failure: Determinants of two-year survivalen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH:khkyiu@hku.hken_US
dc.identifier.authorityYiu, KH=rp01490en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.athoracsur.2010.09.074en_US
dc.identifier.pmid21256300-
dc.identifier.scopuseid_2-s2.0-78751671151en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78751671151&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume91en_US
dc.identifier.issue2en_US
dc.identifier.spage491en_US
dc.identifier.epage498en_US
dc.identifier.isiWOS:000286456400046-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWitkowski, TG=7003737196en_US
dc.identifier.scopusauthoridTen Brinke, EA=24074899300en_US
dc.identifier.scopusauthoridDelgado, V=24172709900en_US
dc.identifier.scopusauthoridNg, ACT=15726084000en_US
dc.identifier.scopusauthoridBertini, M=22033600300en_US
dc.identifier.scopusauthoridMarsan, NA=23035780700en_US
dc.identifier.scopusauthoridEwe, SH=23993827400en_US
dc.identifier.scopusauthoridAuger, D=35723808000en_US
dc.identifier.scopusauthoridYiu, KH=35172267800en_US
dc.identifier.scopusauthoridBraun, J=7403053133en_US
dc.identifier.scopusauthoridKlein, P=36778747600en_US
dc.identifier.scopusauthoridSteendijk, P=7006132724en_US
dc.identifier.scopusauthoridVersteegh, MIM=6701386617en_US
dc.identifier.scopusauthoridKlautz, RJ=6601957932en_US
dc.identifier.scopusauthoridBax, JJ=35379683700en_US
dc.identifier.citeulike8761951-

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