Does quantitative left ventricular regional wall motion change after fibrous tissue resection in endomyocardial fibrosis?
Clinics
; 64(1): 17-22, 2009. ilus, graf
Artigo
em Inglês
| LILACS
| ID: lil-501882
Biblioteca responsável:
BR1.1
ABSTRACT
OBJECTIVES:
We compared left ventricular regional wall motion, the global left ventricular ejection fraction, and the New York Heart Association functional class pre- and postoperatively.INTRODUCTION:
Endomyocardial fibrosis is characterized by fibrous tissue deposition in the endomyocardium of the apex and/or inflow tract of one or both ventricles. Although left ventricular global systolic function is preserved, patients exhibit wall motion abnormalities in the apical and inferoapical regions. Fibrous tissue resection in New York Heart Association FC III and IV endomyocardial fibrosis patients has been shown to decrease morbidity and mortality.METHODS:
We prospectively studied 30 patients (20 female, 30±10 years) before and 5±8 months after surgery. The left ventricular ejection fraction was determined using the area-length method. Regional left ventricular motion was measured by the centerline method. Five left ventricular segments were analyzed pre- and postoperatively. Abnormality was expressed in units of standard deviation from the mean motion in a normal reference population.RESULTS:
Left ventricular wall motion in the five regions did not differ between pre- and postoperative measurements. Additionally, the left ventricular ejection fraction did not change after surgery (0.45±0.13 percent x 0.43±0.12 percent pre- and postoperatively, respectively). The New York Heart Association functional class improved to class I in 40 percent and class II in 43 percent of patients postoperatively (p<0.05).CONCLUSIONS:
Although endomyocardial fibrosis patients have improved clinical symptoms after surgery, the global left ventricular ejection fraction and regional wall motion in these patients do not change. This finding suggests that other explanations, such as improvements in diastolic function, may be operational.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
Base de dados:
LILACS
Assunto principal:
Complicações Pós-Operatórias
/
Disfunção Ventricular Esquerda
/
Fibrose Endomiocárdica
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Fatores de risco
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Clinics
Assunto da revista:
Medicina
Ano de publicação:
2009
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Estados Unidos
Instituição/País de afiliação:
Massachusetts General Hospital/US
/
Universidade de São Paulo/BR