Assessment of the Changes of Left Ventricular Synchrony after Left Ventricular Reconstruction Surgery with Magnetic Resonance Imaging_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FANHong-guang ¹ , FENGWei ¹ , ZHENGZhe ¹ , ZHANGYan ² , JINLi-xin ³ , YINGKui ⁴ , ZHAOShi-hua ² ,  HUSheng-shou ¹

1. Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P. R. China;
2. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P. R. China;
3. Collaboration Team, Siemens Ltd, China, SIMZ, Shanghai 200010, P. R. China;
4. Department of Biomedical Engineering, Tsinghua University, Beijing 100083, P. R. China;

Corresponding author：

HUSheng-shou, Email: shengshouhu@yahoo.com

Keywords：

Magnetic resonance imaging; Left ventricular aneurysm; Surgery; Synchronization

DOI：

10.7507/1007-4848.20140052

Video：

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Objective To investigate dyssynchrony of non-infarction areas before and after surgical ventricular reconstruction after acute myocardial infarction. Methods Twelve patients with postinfarction ventricular aneurysm and heart failure who underwent left ventricular reconstruction surgery in Fu wai Hospital from June 1,2010 to June 31,2011 were enrolled in this study. There were 9 male and 3 female patients with their age of 53.9±7.0 years. Another 12 healthy volunteers were chosen as the control group including 10 males and 2 females with their age of 30.6±3.8 years. Magnetic resonance imaging (MRI) was examined preoperatively and within 3 months after discharge with same sequences. Tagging images were analysis by using Harmonic Phase (HARP) software to extract the data and the data were put into another software to calculate dyssynchrony index. Results After operation,left ventricular ejection fraction (LVEF) improved from 30.3%±7.7% to 43.4%±6.3% (P<0.05) and left ventricular end-systolic volume index decreased from 68.6±10.8 ml/m² to 32.7±9.0 ml/m² (P<0.05). However,left ventricular dyssynchrony index of non-infarction areas remained stable from 0.82±0.13 to 0.83±0.17 (P>0.05). Conclusion Surgical ventricular reconstruction can significantly improve LVEF and reduce left ventricular volume,but left ventricular synchrony index of non-infarction areas is not changed.

Citation： FANHong-guang, FENGWei, ZHENGZhe, ZHANGYan, JINLi-xin, YINGKui, ZHAOShi-hua, HUSheng-shou. Assessment of the Changes of Left Ventricular Synchrony after Left Ventricular Reconstruction Surgery with Magnetic Resonance Imaging. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(2): 168-173. doi: 10.7507/1007-4848.20140052 Copy

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2.	Cirillo M,Amaducci A,Villa E,et al.A new shape for an old function:lasting effect of a physiologic surgical restoration of the left ventricle.J Cardiothorac Surg,2006,1:40.
3.	Carmichael BB,Setser RM,Stillman AE,et al.Effects of surgical ventricular restoration on left ventricular function:dynamic mrimaging.Radiology,2006,241 (3):710-717.
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5.	Di Donato M,Toso A,Dor V,et al.Surgical ventricular restoration improves mechanical intraventricular dyssynchrony in ischemic cardio myopathy.Circulation,2004,109 (21):2536-2543.
6.	Didonato M,Toso A,Dor V,et al.Mechanical synchrony:role of surgical ventricular restoration in correcting LV dyssynchrony during chamber rebuilding.Heart Fail Rev,2004,9 (4):307-315.
7.	Bader H,Garrigue S,Lafitte S,et al.Intra-left ventricular electromechanical asynchrony.A new independent predictor of severe cardiac events in heart failure patients.J Am Coll Cardiol,2004,43 (2):248-256.
8.	Mollema SA,Liem SS,Suffoletto MS,et al.Left ventricular dyssynchrony acutely after myocardial infarction predicts left ventricular remodeling.J Am Coll Cardiol,2007,50 (16):1532-1540.
9.	Cho GY,Song JK,Park WJ,et al.Mechanical dyssynchrony assessed by tissue Doppler imaging is a powerful predictor of mortality in congestive heart failure with normal QRS duration.J Am Coll Cardiol,2005,46 (12):2237-2243.
10.	Tulner SA,Bax JJ,Bleeker GB,et al.Beneficial hemodynamic and clinical effects of surgical ventricular restoration in patients with ischemic dilated cardiomyopathy.Ann Thorac Surg,2006,82 (5):1721-1727.
11.	Cooley DA,Collins HA,Morris GC,et al.Ventricular aneurysm after myocardial infarction;surgical excision with use of temporary cardiopulmonary bypass.J Am Med Assoc,1958,167 (5):557-560.
12.	Zheng Z,Fan HG,Feng W,et al.Surgery of left ventricular aneurysm:a propensity score-matched study of outcomes following different repair techniques.Interact Cardiovasc Thorac Surg,2009,9 (3):431-436.
13.	Fan HG,Zheng Z,Feng W,et al.Repair of left ventricular aneurysm:ten-year experience in Chinese patients.Chin Med J (Engl),2009,122 (17):1963-1968.
14.	吴洪斌,胡盛寿,周玉燕.左心室巨大室壁瘤手术治疗的中远期随访研究.中华外科杂志,2001,39 (12):928-930.
15.	Dor V,Saab M,Coste P,et al.Left ventricular aneurysm:a new surgical approach.Thorac Cardiovasc Surg,1989,37 (1):11-19.
16.	Byrne MJ,Helm RH,Daya S,et al.Diminished left ventricular dyssynchrony and impact of resynchronization in failing hearts with right versus left bundle branch block.J Am Coll Cardiol,2007,50 (15):1484-1490.
17.	Leclercq C,Faris O,Tunin R,et al.Systolic improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block.Circulation,2002,106 (14):1760-1763.
18.	Lane RE,Chow AW,Chin D,et al.Selection and optimisation of biventricular pacing:the role of echocardiography.Heart,2004,90 (Suppl 6):s10-s16.
19.	Rosen BD,Berger RD.Imaging of myocardial dyssynchrony in congestive heart failure.Heart Fail Rev,2006,11 (4):289-303.
20.	Waldman LK,Covell JW.Effects of ventricular pacing on finite deformation in canine left ventricles.Am J Physiol,1987,252 (5 Pt 2):H1023-H1030.
21.	Helm RH,Leclercq C,Faris OP,et al.Cardiac dyssynchrony analysis using circumferential versus longitudinal strain:implications for assessing cardiac resynchronization.Circulation,2005,111 (21):2760-2767.
22.	Bax JJ,Abraham T,Barold SS,et al.Cardiac resynchronization therapy:Part 1-issues before device implantation.J Am Coll Cardiol,2005,46 (12):2153-2167.
23.	Schreuder JJ,Steendijk P,van der Veen FH,et al.Acute and short-term effects of partial left ventriculectomy in dilated cardiomyopathy:assessment by pressure-volume loops.J Am Coll Cardiol,2000,36 (7):2104-2114.
24.	Moustakidis P,Maniar HS,Cupps BP,et al.Altered left ventricular geometry changes the border zone temporal distribution of stress in an experimental model of left ventricular aneurysm:a finite element model study.Circulation,2002,106 (12 Suppl 1):I168-I175.
25.	Walker JC,Ratcliffe MB,Zhang P,et al.Magnetic resonance imaging-based finite element stress analysis after linear repair of left ventricular aneurysm.J Thorac Cardiovasc Surg,2008,135 (5):1094-1102.
26.	Cleland JG,Daubert JC,Erdmann E,et al.The effect of cardiac resynchronization on morbidity and mortality in heart failure.N Engl J Med,2005,352 (15):1539-1549.
27.	Barosi A,Lunati M,Speca G,et al.Cardiac resynchronization therapy in patients undergoing open-chest cardiac surgery.J Interv Card Electrophysiol,2011,30 (3):251-259.
28.	Osman NF,Kerwin WS,Mcveigh ER,et al.Cardiac motion tracking using CINE harmonic phase (HARP) magnetic resonance imaging.Magn Reson Med,1999,42 (6):1048-1060.
29.	Chalil S,Stegemann B,Muhyaldeen S,et al.Intraventricular dyssynchrony predicts mortality and morbidity after cardiac resynchronization therapy:a study using cardiovascular magnetic resonance tissue synchronization imaging.J Am Coll Cardiol,2007,50 (3):243-252.
30.	Zwanenburg JJ,Götte MJ,Marcus JT,et al.Propagation of onset and peak time of myocardial shortening in time of myocardial shortening in ischemic versus nonischemic cardiomyopathy:assessment by magnetic resonance imaging myocardial tagging.J Am Coll Cardiol,2005,46 (12):2215-2222.

1. Marchenko AV,Cherniavsky AM,Volokitina TL,et al.Left ventricular dimension and shape after postinfarction aneurysm repair.Eur J Cardiothorac Surg,2005,27 (3):475-480.
2. Cirillo M,Amaducci A,Villa E,et al.A new shape for an old function:lasting effect of a physiologic surgical restoration of the left ventricle.J Cardiothorac Surg,2006,1:40.
3. Carmichael BB,Setser RM,Stillman AE,et al.Effects of surgical ventricular restoration on left ventricular function:dynamic mrimaging.Radiology,2006,241 (3):710-717.
4. Taniguchi K,Sakurai M,Takahashi T,et al.Postinfarction left-ventricular aneurysm:regional stress,function,and remodeling after aneurysmectomy.Thorac Cardiovasc Surg,1998,46 (5):253-259.
5. Di Donato M,Toso A,Dor V,et al.Surgical ventricular restoration improves mechanical intraventricular dyssynchrony in ischemic cardio myopathy.Circulation,2004,109 (21):2536-2543.
6. Didonato M,Toso A,Dor V,et al.Mechanical synchrony:role of surgical ventricular restoration in correcting LV dyssynchrony during chamber rebuilding.Heart Fail Rev,2004,9 (4):307-315.
7. Bader H,Garrigue S,Lafitte S,et al.Intra-left ventricular electromechanical asynchrony.A new independent predictor of severe cardiac events in heart failure patients.J Am Coll Cardiol,2004,43 (2):248-256.
8. Mollema SA,Liem SS,Suffoletto MS,et al.Left ventricular dyssynchrony acutely after myocardial infarction predicts left ventricular remodeling.J Am Coll Cardiol,2007,50 (16):1532-1540.
9. Cho GY,Song JK,Park WJ,et al.Mechanical dyssynchrony assessed by tissue Doppler imaging is a powerful predictor of mortality in congestive heart failure with normal QRS duration.J Am Coll Cardiol,2005,46 (12):2237-2243.
10. Tulner SA,Bax JJ,Bleeker GB,et al.Beneficial hemodynamic and clinical effects of surgical ventricular restoration in patients with ischemic dilated cardiomyopathy.Ann Thorac Surg,2006,82 (5):1721-1727.
11. Cooley DA,Collins HA,Morris GC,et al.Ventricular aneurysm after myocardial infarction;surgical excision with use of temporary cardiopulmonary bypass.J Am Med Assoc,1958,167 (5):557-560.
12. Zheng Z,Fan HG,Feng W,et al.Surgery of left ventricular aneurysm:a propensity score-matched study of outcomes following different repair techniques.Interact Cardiovasc Thorac Surg,2009,9 (3):431-436.
13. Fan HG,Zheng Z,Feng W,et al.Repair of left ventricular aneurysm:ten-year experience in Chinese patients.Chin Med J (Engl),2009,122 (17):1963-1968.
14. 吴洪斌,胡盛寿,周玉燕.左心室巨大室壁瘤手术治疗的中远期随访研究.中华外科杂志,2001,39 (12):928-930.
15. Dor V,Saab M,Coste P,et al.Left ventricular aneurysm:a new surgical approach.Thorac Cardiovasc Surg,1989,37 (1):11-19.
16. Byrne MJ,Helm RH,Daya S,et al.Diminished left ventricular dyssynchrony and impact of resynchronization in failing hearts with right versus left bundle branch block.J Am Coll Cardiol,2007,50 (15):1484-1490.
17. Leclercq C,Faris O,Tunin R,et al.Systolic improvement and mechanical resynchronization does not require electrical synchrony in the dilated failing heart with left bundle-branch block.Circulation,2002,106 (14):1760-1763.
18. Lane RE,Chow AW,Chin D,et al.Selection and optimisation of biventricular pacing:the role of echocardiography.Heart,2004,90 (Suppl 6):s10-s16.
19. Rosen BD,Berger RD.Imaging of myocardial dyssynchrony in congestive heart failure.Heart Fail Rev,2006,11 (4):289-303.
20. Waldman LK,Covell JW.Effects of ventricular pacing on finite deformation in canine left ventricles.Am J Physiol,1987,252 (5 Pt 2):H1023-H1030.
21. Helm RH,Leclercq C,Faris OP,et al.Cardiac dyssynchrony analysis using circumferential versus longitudinal strain:implications for assessing cardiac resynchronization.Circulation,2005,111 (21):2760-2767.
22. Bax JJ,Abraham T,Barold SS,et al.Cardiac resynchronization therapy:Part 1-issues before device implantation.J Am Coll Cardiol,2005,46 (12):2153-2167.
23. Schreuder JJ,Steendijk P,van der Veen FH,et al.Acute and short-term effects of partial left ventriculectomy in dilated cardiomyopathy:assessment by pressure-volume loops.J Am Coll Cardiol,2000,36 (7):2104-2114.
24. Moustakidis P,Maniar HS,Cupps BP,et al.Altered left ventricular geometry changes the border zone temporal distribution of stress in an experimental model of left ventricular aneurysm:a finite element model study.Circulation,2002,106 (12 Suppl 1):I168-I175.
25. Walker JC,Ratcliffe MB,Zhang P,et al.Magnetic resonance imaging-based finite element stress analysis after linear repair of left ventricular aneurysm.J Thorac Cardiovasc Surg,2008,135 (5):1094-1102.
26. Cleland JG,Daubert JC,Erdmann E,et al.The effect of cardiac resynchronization on morbidity and mortality in heart failure.N Engl J Med,2005,352 (15):1539-1549.
27. Barosi A,Lunati M,Speca G,et al.Cardiac resynchronization therapy in patients undergoing open-chest cardiac surgery.J Interv Card Electrophysiol,2011,30 (3):251-259.
28. Osman NF,Kerwin WS,Mcveigh ER,et al.Cardiac motion tracking using CINE harmonic phase (HARP) magnetic resonance imaging.Magn Reson Med,1999,42 (6):1048-1060.
29. Chalil S,Stegemann B,Muhyaldeen S,et al.Intraventricular dyssynchrony predicts mortality and morbidity after cardiac resynchronization therapy:a study using cardiovascular magnetic resonance tissue synchronization imaging.J Am Coll Cardiol,2007,50 (3):243-252.
30. Zwanenburg JJ,Götte MJ,Marcus JT,et al.Propagation of onset and peak time of myocardial shortening in time of myocardial shortening in ischemic versus nonischemic cardiomyopathy:assessment by magnetic resonance imaging myocardial tagging.J Am Coll Cardiol,2005,46 (12):2215-2222.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Assessment of the Changes of Left Ventricular Synchrony after Left Ventricular Reconstruction Surgery with Magnetic Resonance Imaging

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