Analysis of clinical and echocardiographic predictors of prognosis following left ventricular remodeling surgery

Craig R. Asher, Mario J. Garcia, Randall C. Starling, Mahmoud El Amrousy, Stavros Maragos, Rita L. Vargo, Gregory M. Scalia, James D. Thomas, Patrick M. McCarthy

Research output: Contribution to journalArticle

Abstract

Left ventricular remodeling surgery (LVR) is an innovative operative procedure that has improved the functional capacity of many pts. with dilated cardiomyopathy. It is unknown whether preoperative clinical and echocardiographic variables can identify patients that will benefit most from this procedure. METHODS: During the period 5/96-10/96, 30 LVR were performed at our institution. Multiple clinical and echocardiographic factors were analyzed in a multivariable logistic regression model to predict outcomes. Echocardiogaphic analysis included detailed parameters of systolic and diastolic function. RESULTS: Of the 30 pts. that underwent LVR (7 F, 23 M), we analyzed 29. One pt. was excluded due to preoperative LVAD insertion. Baseline characteristics for the group included: mean age: 56.2 +/- 8.7; LVEF: 13.8% +/- 5.2, LVIDd: 8.0 +/- 1.1cm, VO2 max - 13.4 +/- 2.3 and peak mitral e wave: 100 cm/s. At follow-up of 2-7 months, 9 (31%) pts. reached 1 or more of 4 endpoints including need for LVAD, transplantation, relisting for transplantation or need for inotropic support. None of the variables assessed reached univariate or multivariate significance predicting these outcomes. In addition, there was no correlation between improvement in LVEF and outcome. CONCLUSION: Our initial experience with LVR demonstrates clinical improvement in most pts. However, clinical and resting echocardiographic parameters are not useful predicting outcomes.

Original languageEnglish (US)
Pages (from-to)427
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - 1997
Externally publishedYes

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Ventricular Remodeling
Transplantation
Logistic Models
Operative Surgical Procedures
Dilated Cardiomyopathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Analysis of clinical and echocardiographic predictors of prognosis following left ventricular remodeling surgery. / Asher, Craig R.; Garcia, Mario J.; Starling, Randall C.; Amrousy, Mahmoud El; Maragos, Stavros; Vargo, Rita L.; Scalia, Gregory M.; Thomas, James D.; McCarthy, Patrick M.

In: Journal of the American Society of Echocardiography, Vol. 10, No. 4, 1997, p. 427.

Research output: Contribution to journalArticle

Asher, CR, Garcia, MJ, Starling, RC, Amrousy, ME, Maragos, S, Vargo, RL, Scalia, GM, Thomas, JD & McCarthy, PM 1997, 'Analysis of clinical and echocardiographic predictors of prognosis following left ventricular remodeling surgery', Journal of the American Society of Echocardiography, vol. 10, no. 4, pp. 427.
Asher, Craig R. ; Garcia, Mario J. ; Starling, Randall C. ; Amrousy, Mahmoud El ; Maragos, Stavros ; Vargo, Rita L. ; Scalia, Gregory M. ; Thomas, James D. ; McCarthy, Patrick M. / Analysis of clinical and echocardiographic predictors of prognosis following left ventricular remodeling surgery. In: Journal of the American Society of Echocardiography. 1997 ; Vol. 10, No. 4. pp. 427.
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abstract = "Left ventricular remodeling surgery (LVR) is an innovative operative procedure that has improved the functional capacity of many pts. with dilated cardiomyopathy. It is unknown whether preoperative clinical and echocardiographic variables can identify patients that will benefit most from this procedure. METHODS: During the period 5/96-10/96, 30 LVR were performed at our institution. Multiple clinical and echocardiographic factors were analyzed in a multivariable logistic regression model to predict outcomes. Echocardiogaphic analysis included detailed parameters of systolic and diastolic function. RESULTS: Of the 30 pts. that underwent LVR (7 F, 23 M), we analyzed 29. One pt. was excluded due to preoperative LVAD insertion. Baseline characteristics for the group included: mean age: 56.2 +/- 8.7; LVEF: 13.8{\%} +/- 5.2, LVIDd: 8.0 +/- 1.1cm, VO2 max - 13.4 +/- 2.3 and peak mitral e wave: 100 cm/s. At follow-up of 2-7 months, 9 (31{\%}) pts. reached 1 or more of 4 endpoints including need for LVAD, transplantation, relisting for transplantation or need for inotropic support. None of the variables assessed reached univariate or multivariate significance predicting these outcomes. In addition, there was no correlation between improvement in LVEF and outcome. CONCLUSION: Our initial experience with LVR demonstrates clinical improvement in most pts. However, clinical and resting echocardiographic parameters are not useful predicting outcomes.",
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AU - Maragos, Stavros

AU - Vargo, Rita L.

AU - Scalia, Gregory M.

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