**7. References**

[1] Kwan J, Shiota T, Agler DA, Popovic ZB, Qin JX, Gillinov MA, Stewart WJ, Cosgrove DM, McCarthy PM, Thomas JD; Realtime three-dimensional echocardiography study. Geometric differences of the mitral apparatus between ischemic and dilated

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation 103

[15] Dor V, Civaia F, Alexandrescu C, Montiglio F. The post-myocardial infarction scarred

[16] Femandez-Golfin C, De Aqustin A, Manzano MC, Bustos A, Sanchez T, Perez de Isla L,

[17] Lang RM, Vignon P, Weinert L, Bednarz J, Korcarz C, Sandelski J, Koch R, Prater D,

[18] Bansal M, Jeffiriess L, Leano R, Mundy J, Marwick TH. Assessment of myocardial

velocity and speckle-tracking. JACC Cardiovasc Imaging. 2010; 3: 121-31 [19] Fieno DS, Kim RJ, Chen EL, Lomasney JW, Klocke FJ, Judd RM. Contrast-enhanced

[20] Isomura T, Suma H, Horii T, Sato T, Kikuchi N. Partial left ventriculectomy,

[21] Geyer H, Caracciolo G, Abe H, Wilansky S, Careri S, Gentile F, Nesser HJ, Khandheria

[22] Reisner SA, Lysyansky P, Agmon Y, Mutlak D, Lessick J, Friedman Z. Global

[23] Leitman M, Lysyansky P, Sidenko S, Shir V, Peleq E, Binenbaum M, Kaluski E,

[24] Isomura T, Notomi Y, Hoshino J, Fukada Y, Katahira S, Kitamura A, Kondo T, Iwasaki

[25] Becker M, Hoffmann R, Kuhl M. Analysis of myocardial deformation based on

[26] Popovic Z, Benejam B, Bian C. Speckle-tracking echocardiography correctly identifies

myocardial infarction. Am J Physiol Heart Circ Physiol. 2007; 292: 2809-16

cardiomyopathy. Eur J Cardiothorac Surg. 2010; 38: 171-5

dysfunction. Int J Cardiovasc Imaging. 2011; 27: 539-46

motion with color kinesis. Circulation. 1996; 93: 1877-85

Echocardiogr. 2010; 23: 351-69; quiz 453-5

Echocardiogr. 2004; 17: 630-3

Echocardiogr. 2004; 17: 1021-9

infarction. Eur Heart J. 2006; 27: 2560-6

Cardiovasc Surg. 2008; 136: 1405-12

1985-91

45

ventricle and congestive heart failure: the preeminence of magnetic resonance imaging for preoperative, intraoperative, and postoperative assessment. J Thorac

Fuentes M, Macaya C, Zamorano J. Cardiac magnetic resonance determinants of functional mitral regurgitation in ischemic and non ischemic left ventricular

Mor-Avi V. Echocardiographic quantification of regional left ventricular wall

viability at dobutamine echocardiography by deformation analysis using tissue

magnetic resonance imaging of myocardium at risk: distinction between reversible and irreversible injury throughout infarct healing. J Am Coll Cardiol. 2000; 36:

ventriculoplasty or valvular surgery for idiopathic dilated cardiomyopathy – the role of intra-operative echocardiography. Eur J Cardiothorac Surg. 2000; 17: 239-

B, Narula J, Senqupta PP. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc

longitudinal strain: a novel index of left ventricular systolic function. J Am Soc

Krakover R, Vered Z. Two-dimensional strain – a novel software for real-time quantitative echocardiographic assessment of myocardial function. J Am Soc

T. Indication of posterior restoration and surgical results in patients with dilated

ultrasonic pixel tracking to determine transmurality in chronic myocardial

segmental left ventricular dysfunction induced by scarring in a rat model of

cardiomyopathy with significant mitral regurgitation: real-time three-dimensional echocardiography study. Circulation. 2003; 107: 1135-40


[2] Dor V, Di Donata M. Ventricular remodeling in coronary artery disease. Curr Opin

[3] Gaudron P, Eilles C, Kugler I, Ertl G. Progressive left ventricular dysfunction and

[4] Kaul S, Spotnitz WD, Glasfeen WP, Touchstone DA. Mechanism of ischemic mitral regurgitation: an experimental evaluation. Circulation. 1991; 84: 2167-80 [5] Lamas GA, Mitchell GF, Flaker GC, Smith SC Jr, Gersh BJ, Basta L, Moye L, Braunwald

[6] Enriquez-Sarano M, Schaff HV, Frye RL. Mitral regurgitation: what causes the leakage is fundamental to the outcome of valve repair. Circulation. 2003; 108: 253-6 [7] Di Mauro M, Di Giammarco G, Vitolla G, Contini M, laco AL, Bivona A, Weltert L,

[8] Isomura T, Horii T, Suma H, Buckberg GD; RESTORE Group. Septal anterior ventricular

[10] Dor V, Sabatier M, Di Donato M, Montiglio F, Toso A, Maioli M. Efficacy of

[11] Di Donato M, Toso A, Maioli M, Sabatier M, Stanley AW Jr, Dor V; RESTORE group.

[12] Athanasuleas CL, Stanley AW Jr, Buckberg GD, Dor V, Di Donato M, Blaskstone EH.

[13] Menicanti L, Di Donat M, Castelvecchio S, Santambrogio C, Montericcio V, Frigiola A,

[14] Kaza AK, Patel MR, Fiser SM, Long SM, Kern JA, Tribble CG, Kron IL. Ventricular

Elliptical Shape to the LV. J Am Coll Cardiol. 2001; 37: 1199-209

form not disease. Eur J Cardiothorac Surg. 2006; 29 Suppl 1: S245-50 [9] Di Donato M, Sabatier M, Montiglio F, Maioi M, Toso A, Fantini F, Dor V. Outcome of

depressed pump function. Am J Cardiol. 1995; 15: 557-61

Semin Thorac Cardiovasc Surg. 2001; 13: 468-75

mitral repair. Heart Fail Rev. 2004; 9: 317-27

mitral insufficiency. Ann Surg. 2002; 235: 828-32

echocardiography study. Circulation. 2003; 107: 1135-40

Cardiol. 1997; 12: 533-7

96: 827-33

Circulation. 1993; 87: 755-63

Ann Thorac Surg. 2006; 81: 2128-34

Cardiovasc Surg. 1998; 116: 50-9

cardiomyopathy with significant mitral regurgitation: real-time three-dimensional

remodeling after myocardial infarction. Potential mechanisms and early predictors.

E, Pfeffer MA. Clinical significance of mitral regurgitation after myocardial infarction. Survival and Ventricular Enlargement Investigators. Circulation. 1997;

Calafiore AM. Impact of no-to-moderate mitral regurgitation on late results after isolated coronary artery bypass grafting in patients with ischemic cardiomyopathy.

exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: treatment

left ventricular aneurysmectomy with patch repair in patients with severely

endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction: comparison with a series of large dyskinetic scars. J Thorac

Intermediate survival and predictors of death after surgical ventricular restoration.

Surgical anterior ventricular endocardial restoration (SAVER) in the dilated remodeled ventricle after anterior myocardial infarction. RESTORE group. Reconstructive Endoventricular Surgery, returning Torsion Original Radius

Buckberg G; RESTORE group. Functional ischemic mitral regurgitation in anterior ventricular remodeling: results of surgical ventricular restoration with and without

reconstruction results in improved left ventricular function and amelioration of


Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation 105

[40] Borger MA, Murphy PM, Alam A, Fazel S, Maqanti M, Armstrong S, Rao V, David TE.

[41] Nair RU, Williams SG, Nwafor KU, Hall AS, Tan LB. Left ventricular volume reduction

[42] Havss U, Tapia M, Baron F, Pouzet B, Shafy A. Papillary muscle sling: a new functional

[43] Matsui Y, Suto Y, Shimura S, Fukada Y, Naito Y, Yasuda K, Sasaki S. Impact of papillary

[44] Rama A, Prascheker L, Barreda E, Gandjbakhch I. Papillary muscle approximation for functional ischemic mitral regurgitation: Ann Thorac Surg. 2007; 84: 2130-1 [45] Masuyama S, Marui A, Shimamoto T, Nonaka M, Tsukiji M, Watanabe N, Ikeda T,

[46] Cox JL, Ad N, Palazzo T, Fitzpatrick S, Suyderhound JP, DeGroot KW, Pirovic EA, Lou

[47] Lindner O, Vogt J, Kammeier A, Wielepp P, Holzinger J, Baller D, Lamp B, Hansky B,

[49] Athanasuleas CL, Buckberg GD, Stanley AW, siler W, Dor V, Di Donato M, Menicanti L,

[50] Jones RH, Velazquez EJ, Michler RE, Sopko G, Oh JK, O'Connor CM, Hill JA, Menicanti

[51] Isomura T, Hoshino J, Fukada Y, Kitamura A, Katahira S, Kondo T, Iwasaki T, Buckberg

[52] Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ. Ischemic mitral

without ventriculectomy. Ann Thorac Surg. 2001; 71: 2046-9

functional mitral regurgitation. Ann Thorac Surg. 2003; 75: 809-11

Thorac Cardiovasc Surg. 2007; 133: 1483-92

Cardiovasc Surg. 2008; 136: 868-75

Cardiothorac Surg. 2008; 34: 1149-57

Semin Thorac Cardiovasc Surg. 2000; 12: 53-5

reconstruction. N Engl J Med. 2009; 360: 1705-17

Doppler assessment. Circulation. 2001; 103: 1759-64

11: 164-71

44: 1439-45

423-31

Initial results of the chordal-cutting operation for ischemic mitral regurgitation. J

approach to mitral repair in patients with ischemic left ventricular dysfunction and

muscles approximation on the adequacy of mitral coaptation in functional mitral regurgitation due to dilated cardiomyopathy. Ann Thorac Cardiovasc Surg. 2005;

Yoshida K, Komeda M. Chordal translocation for ischemic mitral regurgitation may ameliorate tethering of the posterior and anterior mitral leaflets. J Thorac

HC, Duvall WZ, Kim YD. The Maze-III procedure combined with valve surgery.

Korfer R, Horstkotte D, Burchert W. Effect of cardiac resynchronization therapy on global and regional oxygen consumption and myocardial blood flow in patients with non-ischaemic and ischaemic cardiomyopathy. Eur Heart J. 2005; 26: 70-6 [48] Klein P, Bax JJ, Shaw LJ, Feringa HH, Versteegh MI, Dion RA, Klautz RJ. Early and late

outcome of left ventricular reconstruction surgery in ischemic heart disease. Eur J

Almeida de, Oliveria S, Beyersdorf F, Kron IL, Suma H, Kouchoukos NT, Moore W, Oz MC, Fontan F, Scott ML, Accola KA; RESTORE group. J Am Coll Cardiol. 2004;

L, Sadowski Z, Desvigne-Nickens P, Rouleau JL, Lee KL; STICH Hypothesis 2 Investigators. Coronary bypass surgery with or without surgical ventricular

G; RESTORE Group. Volume reduction rate by surgical ventricular restoration determines late outcome in ischaemic cardiomyopathy. Eur J Heart Fail. 2011; 13:

regurgitation: long-term outcome and prognostic implications with quantitative


[27] Dagett, WM, Guyton RA, Mundth ED, Buckley MJ, McEnany MT, Gold HK, Leinbach

[28] Levinsky L, Arani DT, Raza ST, Kohn R, Schimert G. Dacron patch enlargement of

[29] Dor V, Saab M, Coste P, Kornaszewska M, Montigilo F. Left ventricular aneurysm: a

[30] Cooley DA. Ventricular endoaneurysmorrhaphy: a simplified repair for extensive

[31] Hutchins GM, Brawley RK. The influence of cardiac geometry on the results of

[32] Matui Y, Fukada Y, Suto Y, Yamauchi H, Luo B, Miyama M, Sasaki S, Tanabe T, Yasuda

[33] Otsuji Y, Handschumacher MD, Schwammenthal E, Jiang L, Song JK, Guerrero JL,

[34] Otsuji Y, Gilon D, Jiang L, He S, Leavitt M, Roy MJ, Birmingham MJ, Levine RA.

[35] Kumanohoso T, Otsuji Y, Yoshifuku S, Matsukida K, Koriyama C, Kisanuki A, Minagoe

[36] Otsuji Y, Kumanohoso T, Yoshifuku S, Matsukida K, Koriyama C, Kisanuki A, Minagoe

[37] Hueb AC, Jatene FB, Moreira LF, Pomerantzeff PM, Kallas E, de Oliveria SA.

[38] Bolling SF, Pagani FD, Deeb GM, Bach DS. Intermediate-term outcome of mitral reconstruction in cardiomyopathy. J Thorac Cardiovasc Surg. 1998; 115: 381-8 [39] Messas E, Guerrero JL, Handschumacher MD, Conrad C, Chow CM, Sullivan S,

ischemic mitral regurgitation. Circulation. 2001; 104: 1958-63

altered leaflet tethering geometry. Circulation. 1997; 96: 1999-2008

infarction. J Thorac Cardiovasc Surg. 2003; 125: 135-43

K. Overlapping cardiac volume reduction operation. J Thorac Cardiovasc Surg.

Vlahakes GJ, Levine RA. Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of

Restricted diastolic opening of the mitral leaflets in patients with left ventricular dysfunction: evidence for increased valve tethering. J Am Coll Cardiol. 1998; 32:

S, Levine RA, Tei C. Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: quantitative analsis of left ventricular and mitral valve geometry in 103 patients with prior myocardial

S, Levine RA, Tei C. Isolated annular dilation does not usually cause important functional mitral regurgitation: comparison between patients with lone atrial fibrillation and those with idiopathic or ischemic cardiomyopathy. J Am Coll

Ventricular remodeling and mitral valve modifications in dilated cardiomyopathy: new insights from anatomic study. J Thorac Cardiovasc Surg.

Yoganathan AP, Levine RA. Chordal cutting: a new therapeutic approach for

infarctectomy. J Thorac Cardiovasc Surg. 1979; 77: 753-6

postinfarction aneurysm. J Card Surg. 1989; 4: 200-5

ventricular aneurysm repair. Am J Pathol. 1980; 99: 221-30

new surgical approach. Thorac Cardiovasc Surg. 1989; 37: 11-9

Gurg. 1977; 186: 260-71

2002; 124: 395-7

398-404

Cardiol. 2002; 15: 1651-6

2002; 124: 1216-24

RC, Austen WG. Surgery for post-myocardial infarct ventricular septal defect. Ann

anterior wall of left ventricule after aneurysmectomy with concomitant


**6** 

*Russia* 

**Morphological Predictors and Molecular** 

**Remodeling of Left Ventricle in Patients with** 

Vladimir Shipulin1, Vitaly Kazakov1,2, Alexander Lezhnev1, Boris Kozlov1,

Coronary artery disease takes a leading role in the etiology of chronic heart insufficiency in 60% of the cases (Belenkov et al., 2002; Kalon et al., 1993; Oganov & Maslennikova, 2000; Simonsen, 2003). According to the data of different authors patients with coronary artery disease experience development of ischemic cariomyopathy preconditioned by diffuse, significantly pronounced atherosclerosis of coronary arteries manifesting as cardiomegaly termed as "heart remodeling" and symptoms of congestive heart failure in 10-35% of the

Postinfarction left ventricular remodeling is one of the most urgent challenges of modern cardiology and cardiac surgery. The heart remodeling process is a combination of changes in cavities' form and volume and in mass of postinfarction heart myocardium in response to significant inadequate hemodynamic conditions of its functioning not connected with sarcomeres elongation caused by their prior overstretching (Jackson, 2002; Maisch, 1996; Rosenberg & Nepomnyashchih, 2003). Among the patients with different cardiomyopathies these are the ones with ischemic cardiomyopathy who have the most unfavorable prognosis, which makes the problem of ischemic heart failure much more significant (Bellenger, 2000;

Quite frequently the surgical intervention becomes the only treatment method for the patients with chronic heart insufficiency basing on deep changes of functional myocardium morphology. Different approaches to surgical ventricular reconstruction aimed at mechanical changes of the heart cavities sizes in combination with coronary artery bypass grafting (CABG) take the leading place in the complex treatment of this pathology. Nevertheless their outcomes show that in the late postoperative period repeated heart remodeling and CHF progressing i.e. return to the initial preoperative values of the heart cavities sizes and functional capacity of the heart takes place in a part of the operated patients (Batista, 1996; Dickstein, 1997; Dor, 1985; Gradinac, 1998; Menicanti & Di Donato,

**1. Introduction 1.1 Background** 

cases (Belenkov et al., 2002; Mareev, 2002).

Buckberg, 2005; Frazier, 2000).

**Markers of Progressing Postoperative** 

Vadim Babokin1, Sergey Gutor2 and Irina Suhodolo2

**Ischemic Cardiomyopathy** 

*1Tomsk Institute of Cardiology, Tomsk, 2Siberian State Medical University, Tomsk,* 

