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Effect of Left Ventricular Restrictive filling pattern on survival in ischemic cardiomyopathy: Implications for surgical ventricular restoration.
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  • srilakshmi adhyapak,
  • Tinku Thomas,
  • Tivlin Maria,
  • Kiron Varghese
srilakshmi adhyapak
narayana hrudayalaya

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Tinku Thomas
St John's National Academy of Health Sciences
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Tivlin Maria
St John's Medical College Hospital
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Kiron Varghese
St John's National Academy of Health Sciences
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Background: To evaluate the effects of baseline left ventricular restrictive filling pattern (RFP; E/A>2) in ischemic cardiomyopathy (ICM) patients on prognosis. Methods: Patient data was retrospectively analyzed over a period of 4.5 years to determine the effect of Echocardiographic factors on survival and re-admission for heart failure. Results: There were 102 ICM patients who had baseline RFP. We identified two sub-groups based on geometric phenotypes of left ventricular eccentric remodeling and dilated remodeling based on the relative wall thickness (RWT >0.34 or <0.34). The patients with preserved RWT had significantly more dilated ventricles ( LVIDd and LVIDs), greater pulmonary artery systolic pressures (PASP), greater diatolic dysfunction (E/A) and less left ventricular ejection fraction (LVEF); p<0.001. The number of deaths was higher in the reduced RWT patients, as were the number of re-admissions, although the time to survival and time to re-admission was not significant. Conclusions: In this pilot study on ICM patients in advanced heart failure with baseline RFP, the presence of preserved RWT indicative of eccentric remodelling demonstrated a better clinical outcome, leading to a hypothesis that the eccentric remodelling LV phenotype might benefit with SVR.