The effects of partial left ventriculectomy on exercise capacity and quality of life in patients with dilated cardiomyopathy

Purpose: Early experience suggests that partial left ventriculectomy (PLV) improves cardiac function. We sought to assess the changes in exercise capacity and quality of life in patients with dilated cardiomyopathy after PLV, which have not been investigated yet. Methods: Seven patients in New York Heart Association functional class IV due to idiopathic cardiomyopathy (mean EF of 17.8 ± 6.9) underwent PLV via median sternotomy. Symptom-limited cardiopulmonary exercise tests, 6-min walk distances (6MWD), and sickness impact profile (SIP) scores were done before, and at 236±104 days. Results: All patients had significant improvements in 6MWD ((300.7 ± 46.1 vs 457.1 ± 100.1 m, p<0.01). Overall SIP scores were lower (11.4 ± 3.1 vs 20.64 ± 42 p<0.05) and was manifested in a decrease in both the physical dimension scores (3.6 ± 1.3 vs 11.7 ± 2.8, p<0.02) and the psychosocial dimension scores (9.7 ± 2.3 vs 17.5 ± 2.96, p<0.005). On cardiopulmonary exercise testing, two patients showed improvement in oxygen uptake at peak exercise (8.9 ± 0.8 vs 12.3 ± 1.2 ml/kg/min), maximum oxygen pulse (7.5 ± 0.7 vs 9.5 ± 0.8), maximum minute ventilation (44.05 ± 2.3 vs 48.8 ± 2.8), and anaerobic threshold (28.5 ± 4.2 vs 37.5 ± 3.8). This change was associated with comparable improvement in echocardiographic measurements compared to baseline. Conclusions: This study provides objective data that PLV is associated with improved quality of life and exercise endurance rather than maximal exercise capacity. Clinical Implications: PLV may prove to be a bridge or even an alternative to transplantation.