loading page

Effect of Left Ventricular Restrictive filling pattern on survival in ischemic cardiomyopathy: Implications for surgical ventricular restoration.
  • +1
  • srilakshmi adhyapak,
  • Tinku Thomas,
  • Tivlin Maria,
  • Kiron Varghese
srilakshmi adhyapak
narayana hrudayalaya

Corresponding Author:[email protected]

Author Profile
Tinku Thomas
St John's National Academy of Health Sciences
Author Profile
Tivlin Maria
St John's Medical College Hospital
Author Profile
Kiron Varghese
St John's National Academy of Health Sciences
Author Profile

Abstract

Background: To evaluate the effects of baseline left ventricular restrictive filling pattern (RFP; E/A>2) in ischemic cardiomyopathy (ICM) patients on prognosis. Methods: Patient data was retrospectively analyzed over a period of 4.5 years to determine the effect of Echocardiographic factors on survival and re-admission for heart failure. Results: There were 102 ICM patients who had baseline RFP. We identified two sub-groups based on geometric phenotypes of left ventricular eccentric remodeling and dilated remodeling based on the relative wall thickness (RWT >0.34 or <0.34). The patients with preserved RWT had significantly more dilated ventricles ( LVIDd and LVIDs), greater pulmonary artery systolic pressures (PASP), greater diatolic dysfunction (E/A) and less left ventricular ejection fraction (LVEF); p<0.001. The number of deaths was higher in the reduced RWT patients, as were the number of re-admissions, although the time to survival and time to re-admission was not significant. Conclusions: In this pilot study on ICM patients in advanced heart failure with baseline RFP, the presence of preserved RWT indicative of eccentric remodelling demonstrated a better clinical outcome, leading to a hypothesis that the eccentric remodelling LV phenotype might benefit with SVR.