Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy
Background: To evaluate the effects of Left ventricular remodeling patterns in patients with left ventricular restrictive filling pattern (RFP; E/A>2) in ischemic cardiomyopathy (ICM) on prognosis. Methods: Patient data was retrospectively analyzed over a period of 4.5 years to determine the effe...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483222000682 |
| _version_ | 1811333093229854720 |
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| author | Srilakshmi M. Adhyapak Tinku Thomas Ms Tivlin Jose Kiron Varghese |
| author_facet | Srilakshmi M. Adhyapak Tinku Thomas Ms Tivlin Jose Kiron Varghese |
| author_sort | Srilakshmi M. Adhyapak |
| collection | DOAJ |
| description | Background: To evaluate the effects of Left ventricular remodeling patterns in patients with left ventricular restrictive filling pattern (RFP; E/A>2) in ischemic cardiomyopathy (ICM) on prognosis. Methods: Patient data was retrospectively analyzed over a period of 4.5 years to determine the effect of LV geometry by Echocardiographic parameterson survival and re-admission for heart failure. All patients with previous history of transmural myocardial infarction were studied and all were on guideline directed medical therapy. None underwent device therapy or surgery. The stored 2D Echocardiograms were studied. Left ventricular dimensions were noted, including the relative wall thickness (RWT). The patients were grouped based on RWT<0.34 and ≥ 0.34 and were compared for clinical outcomes of mortality and re-admissions for heart failure, over a period of 54 months. 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. |
| first_indexed | 2024-04-13T16:46:42Z |
| format | Article |
| id | doaj.art-a06a2fd285df4ef788b2965af5d1ca18 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-04-13T16:46:42Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-a06a2fd285df4ef788b2965af5d1ca182022-12-22T02:39:03ZengElsevierIndian Heart Journal0019-48322022-05-01743206211Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathySrilakshmi M. Adhyapak0Tinku Thomas1Ms Tivlin Jose2Kiron Varghese3Department of Cardiology, St. John's Medical College Hospital, India; Corresponding author. Dept of Cardiology, St. John's Medical College Hospital, Bangalore, 560034, India.Department of Cardiology, St. John's Medical College Hospital, India; Dept of Biostatistics, St. John's Research Institute, IndiaDepartment of Cardiology, St. John's Medical College Hospital, IndiaDepartment of Cardiology, St. John's Medical College Hospital, IndiaBackground: To evaluate the effects of Left ventricular remodeling patterns in patients with left ventricular restrictive filling pattern (RFP; E/A>2) in ischemic cardiomyopathy (ICM) on prognosis. Methods: Patient data was retrospectively analyzed over a period of 4.5 years to determine the effect of LV geometry by Echocardiographic parameterson survival and re-admission for heart failure. All patients with previous history of transmural myocardial infarction were studied and all were on guideline directed medical therapy. None underwent device therapy or surgery. The stored 2D Echocardiograms were studied. Left ventricular dimensions were noted, including the relative wall thickness (RWT). The patients were grouped based on RWT<0.34 and ≥ 0.34 and were compared for clinical outcomes of mortality and re-admissions for heart failure, over a period of 54 months. 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.http://www.sciencedirect.com/science/article/pii/S0019483222000682Left ventricleHeart failureIschemic cardiomyopathyRestrictive filling pattern |
| spellingShingle | Srilakshmi M. Adhyapak Tinku Thomas Ms Tivlin Jose Kiron Varghese Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy Indian Heart Journal Left ventricle Heart failure Ischemic cardiomyopathy Restrictive filling pattern |
| title | Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy |
| title_full | Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy |
| title_fullStr | Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy |
| title_full_unstemmed | Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy |
| title_short | Effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy |
| title_sort | effect of left ventricular geometric remodeling on restrictive filling pattern and survival in ischemic cardiomyopathy |
| topic | Left ventricle Heart failure Ischemic cardiomyopathy Restrictive filling pattern |
| url | http://www.sciencedirect.com/science/article/pii/S0019483222000682 |
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