Serial assessment of rest and exercise left ventricular ejection fraction (LVEF) post-cardiomyoplasty

Full text: Previous studies have shown that the patient's functional class as well as overall quality of life significantly improved with cardiomyoplasty (CM). However, results of objective measurement of left ventricular function remains controversial. The aim of this study was to determine whether there is objective improvement in left ventricular function following cardiomyoplasty. Method: 26 patients with class III New York Heart Association (NYHA) heart failure (mean age 58±7 years) were randomised to cardiomyoplasty (n=12) or control (n=14). Aetiology was idiopathic dilated cardiomyopathy in 85% and ischaemic heart disease in 15%. Groups were well matched at baseline with respect to sex, age, aetiology, NYHA functional class and baseline ejection fraction. Symptom-limited maximal bicycle exercise tests were performed pre-operatively and at 3, 6, 12, 24, and 36 months post-operatively. Resting LVEF: Although some increase in resting LVEF was noted in each group, this increase was not statistically significant (p> 0.05) when compared to baseline. Exercise LVEF: Significant increase in LVEF at peak exercise was noted at six months (p=0.04), 12 months (p=0.03) and 24 months (p=0.01) in the CM group but not in the control group or in the CM group at three months. In conclusion the significant increase in LVEF with exercise in the CM group contributes to the symptomatic improvement seen in the majority of CM patients, and strongly supports the hypothesis of direct systolic assist as one of the mechanisms. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc