Does quantitative left ventricular regional wall motion change after fibrous tissue resection in endomyocardial fibrosis?

Authors

  • Vera Maria Cury Salemi Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • Fabio Fernandes Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • Raquel Sirvente Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • Luciano Nastari Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • Leonardo Vieira Rosa Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • Cristiano A. Ferreira Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • José Luiz Barros Pena Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute
  • Michael H. Picard Massachusetts General Hospital; Cardiology Division; Cardiac Ultrasound Laboratory
  • Charles Mady Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Heart Institute

DOI:

https://doi.org/10.1590/S1807-59322009000100004

Keywords:

Endomyocardial fibrosis, Wall motion, Restrictive cardiomyopathy, Ejection fraction, Surgery

Abstract

OBJECTIVES: We compared left ventricular regional wall motion, the global left ventricular ejection fraction, and the New York Heart Association functional class pre- and postoperatively. INTRODUCTION: Endomyocardial fibrosis is characterized by fibrous tissue deposition in the endomyocardium of the apex and/or inflow tract of one or both ventricles. Although left ventricular global systolic function is preserved, patients exhibit wall motion abnormalities in the apical and inferoapical regions. Fibrous tissue resection in New York Heart Association FC III and IV endomyocardial fibrosis patients has been shown to decrease morbidity and mortality. METHODS: We prospectively studied 30 patients (20 female, 30±10 years) before and 5±8 months after surgery. The left ventricular ejection fraction was determined using the area-length method. Regional left ventricular motion was measured by the centerline method. Five left ventricular segments were analyzed pre- and postoperatively. Abnormality was expressed in units of standard deviation from the mean motion in a normal reference population. RESULTS: Left ventricular wall motion in the five regions did not differ between pre- and postoperative measurements. Additionally, the left ventricular ejection fraction did not change after surgery (0.45±0.13% x 0.43±0.12% pre- and postoperatively, respectively). The New York Heart Association functional class improved to class I in 40% and class II in 43% of patients postoperatively (p<0.05). CONCLUSIONS: Although endomyocardial fibrosis patients have improved clinical symptoms after surgery, the global left ventricular ejection fraction and regional wall motion in these patients do not change. This finding suggests that other explanations, such as improvements in diastolic function, may be operational.

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Published

2009-01-01

Issue

Section

Clinical Sciences

How to Cite

Salemi, V. M. C., Fernandes, F., Sirvente, R., Nastari, L., Rosa, L. V., Ferreira, C. A., Pena, J. L. B., Picard, M. H., & Mady, C. (2009). Does quantitative left ventricular regional wall motion change after fibrous tissue resection in endomyocardial fibrosis? . Clinics, 64(1), 17-22. https://doi.org/10.1590/S1807-59322009000100004