Russian Heart Failure Journal 2004year Left ventricular remodeling in patients with severe chronic heart failure
Left ventricular remodeling in patients with severe chronic heart failure
Uskova O.V., Gendlin G.E., Storozhakov G.I.
Aim: Evaluating the relationship of remodeling parameters and state of different left ventricular (LV) divisions with parameters of LV global function and also revealing clinical and hemodynamic parameters defining appearance of major symptoms in chronic heart failure (CHF) and survival of patients with CHF. Materials and methods. Sixty patients with III NYHA functional class CHF of varying etiology and LV ejection fraction <40% were followed up for 3 years. At baseline all patients have undergone echocardiography including both a routine examination and the measurement of cross-section areas at different LV levels (in both systole and diastole) with subsequent calculation of amplitude and area of contraction fraction for each section. Results: Over the follow-up period, 25 patients died. State of the LV division at the level of papillary muscles had the highest impact on formation of LV global systolic and diastolic function. Among all LV parameters, only parameters of meridianal stress such as end-systolic stress (ESS) and myocardial stress equivalent (MSE) exerted a significant rffect on survival of patients. According to results of regression analysis (including parameters of hemodynamics, remodeling and pronouncement of CHF clinical symptoms), major predictors of death rate were the right ventricular area in diastole; pronouncement of weakness; and MSE.