ORIGINAL ARTICLE   

Minerva Cardioangiologica 2019 August;67(4):261-71

DOI: 10.23736/S0026-4725.19.04856-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Relationships between left ventricular geometry and remodeling in dilated cardiomyopathy

Ewa DZIEWIĘCKA ¹✉, Sylwia WIŚNIOWSKA-ŚMIAŁEK ¹, Lusine KHACHATRYAN ², Aleksandra KARABINOWSKA ², Maria SZYMONOWICZ ², Piotr PODOLEC ¹, Paweł RUBIŚ ¹

¹ Department of Cardiac and Vascular Diseases, Medical College, John Paul II Hospital, Jagiellonian University, Krakow, Poland; ² Department of Cardiac and Vascular Diseases, Medical Collage, Jagiellonian University, Krakow, Poland

BACKGROUND: Since left ventricular reverse remodeling (LVRR) and sphericity index (SI) are correlated with DCM patients’ survival, we attempted to establish the relationship between LVRR, SI and left ventricle (LV) dimensions.
METHODS: In 70 DCM patients, we measured EF, LV transverse (sLVd) and longitudinal (lLVd) diameters at hospital admission, then after 3 and 12 months. SI was assessed thus: SI=sLVd/lLVd.
RESULTS: LVRR was present in 32 patients (52%). SI measurements were similar in LVRR-present and -absent groups at baseline (0.71 vs. 0.70) and differed after 3 and 12 months (0.61 vs. 0.72, P<0.005; 0.59 vs. 0.73, P<0.001; respectively). During 12 months, SI and sLVd decreased in the LVRR-present (0.71 vs. 0.61 vs. 0.59, P<0.05; 5.75 vs. 5.00 vs. 4.82 cm, P<0.001; respectively) and increased in the LVRR-absent cohort (0.70 vs. 0.72 vs. 0.73, P<0.001; 6.01 vs. 6.15 vs. 6.67, P<0.001; respectively). lLVd remained stable (8.23 vs. 8.16 vs. 8.38cm; 8.66 vs. 8.85 vs. 9.13 cm; respectively). SI was significantly correlated with sLVd but not with lLVd. At 3-month follow-up, SI (P<0.005, OR=14000 [95% CI: 5 - 3.9*107]) was found to be a significant LVRR predictor via univariate logistic regression.
CONCLUSIONS: To summarize, changes in sLVd are crucial for changes in LV geometry, whereas lLVd has a negligible effect on this process. The presence of LVRR was not always associated with an improvement in SI and its absence with increase in SI. Since the assessment of SI is less complex than LVRR, SI as a significant LVRR predictor can be useful part of a regular echocardiography examination.

KEY WORDS: Cardiomyopathy, dilated; Diagnostic imaging; Physiopathology; Heart failure; Ventricular remodeling