Semyashkin Andrey, Nesteruk Julia, Giannikopouloui Dimitra, Scheid Michael, Tarusinov Gleb, Tannous Aktam, Te Vrugt Marcel, Ben Mime Lotfi
Department of Pediatric Cardiac Surgery, University Hospital Muenster, Muenster, Germany.
University Heart Center Freiburg Bad Krozingen, Freiburg, Germany.
Cardiol Young. 2025 Apr;35(4):717-721. doi: 10.1017/S1047951125000460. Epub 2025 Feb 27.
To retrospectively assess the suitability of pulmonary artery banding as a treatment strategy for dilated cardiomyopathy and left ventricular non-compaction cardiomyopathy with depressed left ventricular ejection fraction.
The study was retrospective and included consecutive patients who met the inclusion criteria: diagnosed with dilated cardiomyopathy or left ventricular non-compaction cardiomyopathy and left ventricular ejection fraction less than 35%. Cardiac indices were documented, and clinical outcomes were followed for 5 years.
This study included 21 patients with depressed left ventricular ejection fraction due to dilated cardiomyopathy (n = 11) or left ventricular non-compaction cardiomyopathy (n = 10), treated either with anti-congestion medication alone or in combination with pulmonary artery banding. The groups treated with pulmonary artery banding showed significant improvement in left ventricular ejection fraction compared to controls (ANOVA, = 0.0002), with no major adverse events. In the subgroup with left ventricular non-compaction, pulmonary artery banding led to significant improvement of the left ventricular ejection fraction ( = 0.00002) and significant reductions in the Z scores of left ventricular end-diastolic diameter ( = 0.0002) and of end-diastolic volume ( = 0.004).
Pulmonary artery banding appears to be a viable strategy for improving heart function in patients with non-compaction and dilated cardiomyopathy and depressed left ventricular ejection fraction. While pulmonary artery banding demonstrated more pronounced benefits in the subgroup with non-compaction cardiomyopathy, significantly enhancing cardiac restoration indices throughout the follow-up period, warranting further investigation in larger studies.
回顾性评估肺动脉环扎术作为扩张型心肌病和左心室心肌致密化不全伴左心室射血分数降低的治疗策略的适用性。
本研究为回顾性研究，纳入符合纳入标准的连续患者：诊断为扩张型心肌病或左心室心肌致密化不全且左心室射血分数低于35%。记录心脏指数，并随访5年的临床结局。
本研究纳入了21例因扩张型心肌病（n = 11）或左心室心肌致密化不全（n = 10）导致左心室射血分数降低的患者，这些患者单独接受抗充血药物治疗或联合肺动脉环扎术治疗。与对照组相比，接受肺动脉环扎术治疗的组左心室射血分数有显著改善（方差分析，P = 0.0002），且无重大不良事件。在左心室心肌致密化不全亚组中，肺动脉环扎术使左心室射血分数显著改善（P = 0.00002），左心室舒张末期直径的Z评分显著降低（P = 0.0002），舒张末期容积显著降低（P = 0.004）。
肺动脉环扎术似乎是改善心肌致密化不全和扩张型心肌病伴左心室射血分数降低患者心脏功能的可行策略。虽然肺动脉环扎术在心肌致密化不全心肌病亚组中显示出更明显的益处，在整个随访期间显著提高了心脏恢复指标，但仍需在更大规模的研究中进一步研究。
