May 1, 1995Circulation
Reverse Remodeling From Cardiomyoplasty in Human Heart Failure
Key result
Cardiomyoplasty in three patients with dilated cardiomyopathy lowered cardiac end-diastolic volume and increased ejection fraction, suggesting reversal of chronic chamber remodeling.
Why the study?
Does cardiomyoplasty reverse chamber remodeling in patients with dilated cardiomyopathy?
Population
n=3 patients with dilated cardiomyopathy (New York Heart Association class III)
Comparison
Cardiomyoplasty vs Baseline (before surgery) and pacing-off beats
Design
Case_series
Follow-up
6 and 12 months
Authors
Discussion
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Implication
Supports passive constraint as remodeling mechanism in dilated cardiomyopathy; hypothesis-generating, should not change practice.
Study Design
Type
Observational (n=3)
Structured PICO
Does cardiomyoplasty reverse chamber remodeling in patients with dilated cardiomyopathy?
P
Population
n=3 patients with dilated cardiomyopathy (New York Heart Association class III)
I
Intervention
Cardiomyoplasty (latissimus dorsi muscle wrapped around the heart and chronically paced synchronously with ventricular systole)
C
Comparator
Baseline (before surgery) and pacing-off beats
O
Outcome
Serial pressure-volume relation analysis (chronic left ventricular systolic and diastolic changes) at 6 and 12 monthssurrogate
Cardiomyoplasty may reverse remodeling of the dilated failing heart primarily through a passive, elastic constraint effect rather than active systolic assist.
Limitations
- Limited to a small number of patients
- limited to a small number of patients
Cite This Study
Kass et al. (1995) conducted an observational in Dilated cardiomyopathy (n=3). Cardiomyoplasty vs. Baseline (before surgery) was evaluated on Serial pressure-volume relation analysis (chronic left ventricular systolic and diastolic changes). Cardiomyoplasty in three patients with dilated cardiomyopathy lowered cardiac end-diastolic volume and increased ejection fraction, suggesting reversal of chronic chamber remodeling.