Influence of baseline left ventricular function on the clinical outcome of surgical ventricular reconstruction in patients with ischaemic cardiomyopathy.

Jk, O; Velazquez, E; Menicanti, L; Pohost, G; Bonow, R; Lin, G; Hellkamp, A; Ferrazzi, P; Wos, S; Rao, V; Berman, D; Bochenek, A; Cherniavsky, A; Rogowski, J; Rouleau, J; Lee, K; Investigators, S; Cherniavsky, A; Marchenko, A; Romanov, A; Wos, S; Deja, M; Golba, K; Malinowski, M; Gradinac, S; Kosevic, D; Vukovic, M; Djokovic, L; Krzeminska-Pakula, M; Jaszewski, R; Drozdz, J; Chrzanowski, L; Rajda, M; Ali, I; Howlett, J; Macfarlane, M; Jain, A; Shah, H; Rakshak, D; Saxena, A; Zembala, M; Przybylski, R; Kukulski, T; Wasilewski, J; Wiechowski, S; Brykczynski, M; Kurowski, M; Mokrzycki, K; Sadowski, J; Kapelak, B; Sobczyk, D; Plicner, D; Wrobel, K; Piegas, L; Paulista, P; Farsky, P; C Veiga Kantorowitz,; Sadowski, Z; Juraszynski, Z; Szwed, H; Dabrowski, R; Rogowski, J; Pawlaczyk, R; Rynkiewicz, A; Betlejewski, P; Siepe, M; Geibel-Zehender, A; Cuerten, C; Higgins, R; Crestanello, J; Binkley, P; Jones, D; Sun, B; Velazquez, E; Smith, P; Milano, C; Adams, P; Hill, J; Beaver, T; Leach, D; Airan, B; 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Nawarawong, W; Woragidpoonpol, S; Kuanprasert, S; Mekara, W; Kon, N; Hammon, J; Wells, G; Tilley, W; Drazner, M; Dimaio, M; Peschka, S; C De Pasquale,; Knight, J; Aylward, P; Thomas, C; Gullestad, L; Sorensen, G; Kaul, U; Gupta, R; J Schmedtje Jr,; Arnold, S; Wilson, V; Grayburn, P; Hamman, B; Hebeler, R; Aston, S; Birjiniuk, V; Harrington, M; Dupree, C; Sheridan, B; Schuler, C; Helou, J; Denis, I; Bigalli, D; Gutierrez, F; Russo, N; Batlle, C; White, H; Alison, P; Stewart, R; Borthwick, L; Philippides, G; Shemin, R; Fitzgerald, C; Dagenais, F; Dussault, G; Kamath, P; Busmann, C; Ferrari, G; Botto, M; Horkay, F; Hartyanszky, I; Bartha, E; Simor, T; Papp, L; Toth, L; Varga-Szemes, A; Horkay, F; Szekely, L; Keltai, M; Edes, I; Szathmarine, V; Yakub, M; Sarip, S; Maitland, A; Isaac, D; Holland, M; Bogats, G; Csepregi, L; Maia, L; Soares, M; Mouco, O; Souza, A; A Cordeiro Da Rocha,; J Reis Brito,; F Monassa Pitella,; A Gurgel Camara,; Horowitz, J; Knight, J; Rose, J; R Mcrae Jr,; Geiss, D; 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O'Connor, C; Oh, J; Rankin, G; Sopko, G; Velazquez, E; Hill, J; Bonow, R; Desvigne-Nickens, P; Doenst, T; Jones, R; Lee, K; Michler, R; Oh, J; Panza, J; Rouleau, J; Sadowski, Z; Sopko, G; Velazquez, E; White, H; Pohost, G; Agarwal, S; Apte, P; Doyle, M; Forder, J; Ocon, M; Pai, R; Reddy, V; Santos, N; Tripathi, R; Varadarajan, P; Oh, J; Pellikka, P; F Miller Jr,; Lin, G; Borgeson, D; Ommen, S; Casaclang-Verzosa, G; Miller, D; Springer, R; Blahnik, F; Manahan, B; Welper, J; Wiste, H; Mark, D; Anstrom, K; Baloch, K; Burnette, A; Cowper, P; Davidson-Ray, N; Drew, L; Harding, T; Hunt, V; Knight, D; Patterson, A; Redick, T; Sanderford, B; Feldman, A; Bristow, M; Chan, T; Maisel, A; Mann, D; Mcnamara, D; Bonow, R; Holly, T; Berman, D; Leonard, S; Helmer, D; Woods, M; Panza, J; Mcnulty, M; Asch, F; Rumsey, M; Bieganski, S; Grayburn, P; Aston, S; Roberts, B; Handschumacher, M; Jones, R; Velazquez, E; O'Connor, C; Rankin, G; Barfield, T; Mccormick, A; Albright, J; Dandridge, R; Rittenhouse, L; Wagstaff, D; Williams, M; Bailey, D; Glover, D; Parrish, L; Wakeley, N; Jackson, V; Nicholson, B; Lee, K; She, L; Mcdaniel, A; Al-Khalidi, H; Greene, D; Moore., V

doi:10.1093/eurheartj/ehs021

Aims TheSurgical Treatment for IschemicHeart Failure (STICH) trial demonstratednooverall benefitwhensurgical ventricularreconstruction(SVR)wasaddedtocoronaryarterybypassgrafting(CABG) inpatientswith ischaemic cardiomyopathy.Thepresent analysiswas todeterminewhether, basedonbaseline left ventricular (LV) function parameters, anysubgroupscouldbeidentifiedthatbenefitedfromSVR. Methods andresults Amongthe1000patientsenrolled,CoreLabmeasuresofbaselineLVfunctionwithadequatequalitywereobtained in710patientsusingechocardiography, in352usingcardiovascularmagneticresonance,andin344usingradionuclide imaging.TherelationshipbetweenLVend-systolicvolumeindex(ESVI),end-diastolicvolumeindex,ejectionfraction (EF), regionalwallmotionabnormalities,andoutcomewerefirstassessedonlybyechocardiographicmeasures,and thenby13algorithmsusingadifferenthierarchyof imagingmodalitiesandtheirquality.ThemedianESVIandEFwere 78.0(range:22.8–283.8)mL/m2and28.0%,respectively.Hazardratioscomparingtherandomizedarmsbysubgroups ofLVESVIandLVEFmeasuredbyechocardiographyfoundthatpatientswithsmallerventricles(LVESVI,60mL/m2) andbetterLVEF(≥33%)mayhavebenefittedbySVR,whilethosewithlargerventricles(LVESVI.90mL/m2)and lowerLVEF(≤25%)didworsewithSVR.Algorithmsusingall threeimagingmodalities foundaweakerrelationship betweenLVglobal functionandtheeffectsofSVR.Theextentofregionalwallmotionabnormalitydidnot influence theeffectsofSVR. Conclusions Subgroup analyses of the STICH trial suggest that patients with less dilated LV and better LVEF may benefit fromSVR, while those with larger LV and poorer LVEF may do worse.

Jk, O., Ej, V., L, M., Gm, P., Ro, B., G, L., et al. (2013). Influence of baseline left ventricular function on the clinical outcome of surgical ventricular reconstruction in patients with ischaemic cardiomyopathy. EUROPEAN HEART JOURNAL, 34(1), 39-47 [10.1093/eurheartj/ehs021].