Recoupling of right and left ventricle pump function after surgical ventricle restoration: a cardiac magnetic resonance study

Int J Cardiovasc Imaging. 2015 Apr;31(4):813-20. doi: 10.1007/s10554-015-0599-9. Epub 2015 Jan 28.

Abstract

To evaluate biventricular pump function after surgical ventricle restoration (SVR) using cardiac magnetic resonance (CMR). We retrospectively studied 39 patients who performed 1.5-T CMR before/after SVR acquiring short-axis ECG-gated cine sequences. End-diastolic, end-systolic, and stroke volume indexed to body surface area (EDVI, ESVI, and SVI), ejection fraction (EF), and their modification after SVR (∆) were obtained for right ventricle (RV) and left ventricle (LV). Wilcoxon signed rank test and Spearman correlation coefficient were used; EF reproducibility was estimated. Median LVEF increased from 24% [interquartile range (IQR) 19-31%] before SVR to 34% (IQR 29-43%) after SVR (P < 0.001). Median RVEF remained unchanged from 58% (IQR 48-66%) before SVR to 57% (IR 46-64%) after SVR (P = 0.743). The correlation between LVEF and RVEF was not significant before SVR (r = 0.182; P = 0.266) but significant after SVR (r = 0.445; P = 0.005). The ∆RVEF was positively correlated with ∆LVEF (r = 0.558; P < 0.001). ∆RVSVI was positively correlated with ∆LVSVI (r = 0.502; P = 0.001). LVEF reproducibility before SVR was 97% for both intra- and inter-reader reproducibility; RVEF reproducibility was 96 and 93%, respectively. SVR improved LV function without apparent impact on RV function. After SVR the two ventricles showed a functional recoupling. Reproducibility of CMR EF was excellent for both ventricles.

MeSH terms

  • Aged
  • Cardiac Surgical Procedures*
  • Cardiac-Gated Imaging Techniques
  • Electrocardiography
  • Female
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery*
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis
  • Hypertrophy, Left Ventricular / etiology
  • Hypertrophy, Left Ventricular / physiopathology
  • Hypertrophy, Left Ventricular / surgery*
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / physiopathology
  • Observer Variation
  • Predictive Value of Tests
  • Recovery of Function
  • Reproducibility of Results
  • Retrospective Studies
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery*
  • Ventricular Function, Left*
  • Ventricular Function, Right*
  • Ventricular Remodeling