Radionuclide study of mid-term left ventricular function after endoventricular circular patch plasty

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Abstract

Objective:

Although the early result of endoventricular circular patch plasty (EVCPP) has been reported, few are seen about the long-term results. We studied left ventricular (LV) function in the early and mid-term periods after EVCPP with electrocardiographic-gated single photon emission computed tomography (Gated SPECT).

Methods:

Consecutive 14 patients with LV asynergy after myocardial infarction, who had the EVCPP procedure, were studied by Gated SPECT. Mean age of patients was 67±10 years. Gated SPECT images were obtained and LV end-diastolic volume index (EDVI), LV end-systolic volume index (ESVI) and ejection fraction (EF) were studied with QGS(+) program. Gated SPECT study was performed before surgery, early (23 days) and mid-term periods (32 months) after surgery.

Results:

EDVI changed significantly from preoperative value to early postoperative value (107±39 to 72±37 ml/m2, P<0.01). There was no significant difference between early and mid-term postoperative values. ESVI also changed significantly from preoperative value to early postoperative value, and from early value to mid-term postoperative value (78±37 to 51±34 to 47±35 ml/m2, P<0.05, respectively). EF increased significantly from preoperative value to early postoperative value, and from early value to mid-term postoperative value (30±10 to 35±13 to 45±18%, P<0.05, respectively).

Conclusions:

Direct influence of EVCPP brought significant improvement of LV function in early period. Further decrease of ESVI and increase of EF were noticed from early period to mid-term period. This result suggest that the effect of EVCPP sustains long and yields reverse LV remodeling.

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