PMID- 12493509
OWN - NLM
STAT- MEDLINE
DCOM- 20030320
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 23
IP  - 1
DP  - 2003 Jan
TI  - Maintained benefits and improved survival of dynamic cardiomyoplasty by 
      activity-rest stimulation: 5-year results of the Italian trial on "demand" 
      dynamic cardiomyoplasty.
PG  - 81-5
AB  - OBJECTIVE: Latissimus dorsi (LD) muscular degeneration caused by continuous 
      electrical stimulation has been the main cause of the poor results of dynamic 
      cardiomyoplasty (DCMP) and its exclusion from the recent international guidelines 
      on heart failure. To avoid full transformation of the LD and to improve results, 
      a new stimulation protocol was developed; fewer impulses per day are delivered, 
      providing the LD wrap with daily periods of rest ("demand" stimulation), based on 
      a heart rate cut-off. The aim of this work is to report the results at 5 years of 
      follow-up of the Italian Trial of Demand Dynamic Cardiomyoplasty and to discuss 
      their impact on the destiny of this type of cardiac assistance. METHODS: Twelve 
      patients with dilated myocardiopathy (M/F=11/1, mean age 58.2+/-5.8 years, sinus 
      rhythm/atrial fibrillation=11/1) were submitted during the period 1993-1996 to 
      DCMP and at different intervals to demand protocol. Clinical, echocardiographic, 
      mechanographic and cardiac invasive assessments were scheduled before initiating 
      the demand protocol and during the follow-up at 0, 6 and every 12 months. 
      RESULTS: The mean duration of follow-up was 40.2+/-13.8 months (range 18-64). 
      There were no perioperative deaths. The demand stimulation protocol showed a 
      decrease in 5 years in New York Health Association (NYHA) class 
      (3.17+/-0.38-1.67+/-0.77, P=0.0001), an improvement of left ventricular ejection 
      fraction (22.6+/-4.38-32.0+/-7.0, P<0.001), a 5-year actuarial survival of 83.3% 
      (one patient was switched to heart transplantation programme due to clinical 
      worsening and another one died of massive pulmonary embolism). CONCLUSIONS: 
      Demand DCMP maintains over time LD muscular properties, enhances clinical 
      benefits and improves survival of DCMP, thus reopening the debate whether this 
      type of treatment should be considered in patients with end-stage heart failure.
FAU - Rigatelli, Gianluca
AU  - Rigatelli G
AD  - Cardiomyoplasty Project Unit, Legnago General Hospital, Via T. Speri 18, 37040 
      Legnago, Verona, Italy. jackyheart@hotmail.com
FAU - Barbiero, Mario
AU  - Barbiero M
FAU - Rigatelli, Giorgio
AU  - Rigatelli G
FAU - Riccardi, Roberto
AU  - Riccardi R
FAU - Cobelli, Franco
AU  - Cobelli F
FAU - Cotogni, Angelo
AU  - Cotogni A
FAU - Bandello, Attilio
AU  - Bandello A
FAU - Carraro, Ugo
AU  - Carraro U
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Cardiomyopathy, Dilated/physiopathology/*surgery/therapy
MH  - Cardiomyoplasty/*methods
MH  - Electric Stimulation Therapy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - *Skeletal Muscle Ventricle/*physiology
MH  - Survival Rate
EDAT- 2002/12/21 04:00
MHDA- 2003/03/21 04:00
CRDT- 2002/12/21 04:00
PHST- 2002/12/21 04:00 [pubmed]
PHST- 2003/03/21 04:00 [medline]
PHST- 2002/12/21 04:00 [entrez]
AID - S1010794002006632 [pii]
AID - 10.1016/s1010-7940(02)00663-2 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2003 Jan;23(1):81-5. doi: 10.1016/s1010-7940(02)00663-2.