Abul Kashem, MD, PhD, Sarmina Hassan, MD, PhD, Deborah L

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Presentation transcript:

Left ventricular reshaping: Effects on the pressure-volume relationship Abul Kashem, MD, PhD, Sarmina Hassan, MD, PhD, Deborah L. Crabbe, MD, David B. Melvin, MD, William P. Santamore, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 2, Pages 391-399 (February 2003) DOI: 10.1067/mtc.2003.4 Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Dr Kashem The Journal of Thoracic and Cardiovascular Surgery 2003 125, 391-399DOI: (10.1067/mtc.2003.4) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Two representative LV end-diastolic short-axis echocardiographic views at papillary muscle level at baseline heart failure and with the CardioClasp. The CardioClasp significantly reduced LV A-P diameter by 25%. The figure shows how the A-P dimension was measured connecting the line immediately below to the anterior and posterior papillary muscles of the left ventricle (A, corner point of the anterior papillary muscle; P, corner point of the posterior papillary muscle). In this image the anterior bar of the CardioClasp device was in front of the anterior papillary muscle and not visible. The posterior bar of the CardioClasp device was at the back of the posterior papillary muscle and poorly visible (slightly echogenic behind the papillary muscle). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 391-399DOI: (10.1067/mtc.2003.4) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Significantly decreased LV wall stress (LVWS) with the CardioClasp by 28.9% ± 4.4%. *P <.05. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 391-399DOI: (10.1067/mtc.2003.4) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Significantly increased LV FAC by 50.9% ± 18.1% with the CardioClasp. *P <.05. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 391-399DOI: (10.1067/mtc.2003.4) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 A, Representative recordings showing LV pressure-volume loops at baseline heart failure and during CardioClasp placement at 25% LV dimension reduction. LV contractility assessed by Emax was significantly higher by 68.0% ± 21.7% with the CardioClasp (P =.01 compared with baseline heart failure). LVV, LV volume; LVP, LV pressure. B, Preload recruitable stroke work (SW) versus end-diastolic volume (EDV) relationship at baseline heart failure (solid bullets and dotted line) and with the CardioClasp (rounded bullets and solid line). The CardioClasp significantly increased the preload recruitable stroke work-end-diastolic volume relationship (P =.02). MSW, Slope of the LV preload recruitable stroke work (in millimeters of mercury); EDV, LV end-diastolic volume (in millimeters). C, Slope of the maximum dP/dt−VED (dP/dtMAX−VED) relationship (dE/dt) at baseline heart failure (solid bullets and dotted line) and with the CardioClasp (rounded bullets and solid line). The CardioClasp significantly increased dE/dt (in millimeters of mercury per second per milliliter), (P =.02). LVdP/dt, First derivative of the LV pressure (in millimeters or mercury per second); EDV, LV end-diastolic volume (in milliliters). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 391-399DOI: (10.1067/mtc.2003.4) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions