Research article summary (published 30 Aug 2009):

Neurohormonal and echocardiographic results after CorCap and mitral annuloplasty for dilated cardiomyopathy.

Full Abstract

BACKGROUND: Restrictive mitral annuloplasty (RMA) can be an effective treatment for functional mitral regurgitation in congestive heart failure (CHF). Passive cardiac restraint is another surgical approach, but the midterm results are not well characterized. METHODS: Thirty patients with functional mitral regurgitation were prospectively randomized to RMA alone or cardiac restraint with the CorCap Cardiac Support Device (Acorn Cardiovascular Inc, St. Paul, MN) and RMA. Clinical, echocardiographic, New York Heart Association (NYHA) functional class, Short Form 36-Item Health Survey (SF-36) quality of life scores, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) results were analyzed. RESULTS: No hospital deaths or device-related complications occurred. The two groups had comparable morbidity (p = 0.34). Echocardiography showed a trend towards a slightly better functional improvement during follow-up in CorCap plus RMA patients (between groups, p = 0.001). Both groups showed improved results for SF-36, NYHA, and NT-pro.BNP; however, CorCap plus RMA patients had significantly better SF-36 at discharge (p = 0.003), postoperative NYHA (p = 0.05), and NT-pro.BNP (p = 0.001). Survival (p = 0.46), freedom from CHF (p = 0.23), and rehospitalization (p = 0.28) were comparable. Patients in whom CHF developed after postoperative day 1 had higher NT-pro.BNP values (p = 0.001 at all time-points). CONCLUSIONS: Adjunctive application of CorCap with RMA correlated with better NT-pro.BNP at short-term follow-up together with slightly improved echocardiographic and functional results. This deserves further evaluation at midterm and long-term follow-up. Reduction of NT-pro.BNP at follow-up may be suggested as a prognostic index.

Author information

Author/s: Rubino, Antonio S (AS); Onorati, Francesco (F); Santarpino, Giuseppe (G); Pasceri, Eugenia (E); Santarpia, Giuseppe (G); Cristodoro, Lucia (L); Serraino, Giuseppe Filiberto (GF); Renzulli, Attilio (A);

Affiliation: Cardiac Surgery Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy. cchumg(-atsign-)hotmail.it

Journal and publication information

Publication Type: Comparative Study; Journal Article; Randomized Controlled Trial

Journal: The Annals of thoracic surgery (Ann Thorac Surg), published in Netherlands. (Language: eng)

Reference: 2009-Sep; vol 88 (issue 3) : pp 719-25

Dates: Created 2009/08/24; Completed 2009/09/14;

PMID: 19699885, status: MEDLINE (last retrieval date: 9/14/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Ann Thorac Surg. 2009 Sep;88(3):726. (PMID: 19699886)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged Cardiomyopathy, Dilated - blood; mortality; surgery; ultrasonography Combined Modality Therapy Echocardiography Echocardiography, Doppler, Color Echocardiography, Transesophageal Female Follow-Up Studies Heart Failure - blood; mortality; surgery; ultrasonography Heart Valve Prosthesis Heart-Assist Devices Humans

Humans Kaplan-Meiers Estimate Male Middle Aged Mitral Valve - surgery; ultrasonography Mitral Valve Insufficiency - blood; mortality; surgery; ultrasonography Natriuretic Peptide, Brain - blood Peptide Fragments - blood Polyesters Postoperative Complications - blood; mortality; ultrasonography Surgical Mesh Ventricular Dysfunction, Left - blood; mortality; surgery; ultrasonography

Associated Chemicals: Peptide Fragments (0) ; Polyesters (0) ; pro-brain natriuretic peptide (1-76) (0) ; Natriuretic Peptide, Brain (114471-18-0)

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