Effects of partial left ventriculectomy on left ventricular performance in patients with nonischemic dilated cardiomyopathy

J Am Coll Cardiol. 1998 Dec;32(7):1801-8. doi: 10.1016/s0735-1097(98)00465-3.


Objectives: This study sought to assess the effects of partial left ventriculectomy (PLV) on left ventricular (LV) performance in a series of consecutive patients with nonischemic dilated cardiomyopathy.

Background: Reduction of LV systolic function in patients with heart failure is associated with an increase of LV volume and alteration of its shape. Recently, PLV, a novel surgical procedure, was proposed as a treatment option to alter this process in patients with dilated cardiomyopathy.

Methods: We studied 19 patients with severely symptomatic nonischemic dilated cardiomyopathy, before and 13+/-3 days after surgery, and 12 controls. Single-plane left ventriculography with simultaneous measurements of femoral artery pressure was performed during right heart pacing.

Results: The LV end-diastolic and end-systolic volume indexes decreased after PLV (from 169 to 102 ml/m2, and from 127 to 60 ml/m2, respectively, p < 0.0001 for both). Despite a decrease in LV mass index (from 162 to 137 g/m2, p < 0.0001), there was a significant decrease in LV circumferential end-systolic and end-diastolic stresses (from 277 to 159 g/cm2, p < 0.0001 and from 79 to 39 g/cm2, p = 0.0014, respectively). Ejection fraction improved (from 24% to 41%, p < 0.0001); the stroke work index remained unchanged.

Conclusions: The PLV improves LV performance by a dramatic reduction of ventricular end-systolic and end-diastolic stresses. Further studies are needed to assess whether this effect is sustained during long-term follow-up and to define the role of PLV in the treatment of patients with dilated cardiomyopathy.

MeSH terms

  • Adult
  • Cardiac Catheterization
  • Cardiomyopathy, Dilated / physiopathology*
  • Cardiomyopathy, Dilated / surgery*
  • Female
  • Heart Ventricles / surgery*
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Stroke Volume
  • Systole
  • Treatment Outcome
  • Ventricular Function, Left*