Background: To evaluate the effects of baseline left ventricular
restrictive filling pattern (RFP; E/A>2) in ischemic
cardiomyopathy (ICM) patients on prognosis. Methods: Patient data was
retrospectively analyzed over a period of 4.5 years to determine the
effect of Echocardiographic factors on survival and re-admission for
heart failure. 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, leading to
a hypothesis that the eccentric remodelling LV phenotype might benefit
with SVR.
Effect of Left Ventricular Restrictive filling pattern on survival in ischemic cardiomyopathy: Implications for surgical ventricular restoration.
