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DOI: 10.1055/s-0042-1742898
Pulmonary Artery Banding for Dilated and Depressed Left Ventricle: DCM versus NCCM
Background: We retrospectively assessed if PAB is an equally suitable treatment strategy for dilated cardiomyopathy with depressed LVEF in two subgroups of children with two distinct etiologies NCCM and DCM.
Method: Twenty-one patients with depressed LVEF (<40%) caused either by myocarditis (DCM) (n = 11) or left ventricular non-compaction (LVNC) (n = 10) underwent functional echocardiography imaging and clinical follow-up over 5 years. Each group was divided into two commensurate subgroups, treated either with anti-congestion medication (ACM) only or ACM plus PAB (ACM-PAB). Cardiac indices such as LVEF, LVEDD, LVEDV, and RVEDD and the clinical course were documented.
Results: All patients survived. Both groups seem to benefit from PAB. No major events (left ventricular assist device, heart transplantation or death) were registered during the follow-up in both subgroups with PAB. Two heart transplantations and one death occurred in the viral DCM subgroup without PAB. Cardiac restoration indices (LVEF, LVEDD and LVEDV) showed recovery of the left ventricular function in all patients but 3 from the DCM-subgroup without PAB. LVEF was steadily and significantly enhanced only in the LVNC subgroup with PAB (p = 0.01) throughout the follow-up period of 5 years. In this same group z-score LVEDD has improved significantly as early as the second follow-up (p = 0.05). The LVNC as well the DCM subgroups showed no significant improvement of LVEF when treated with ACM only.
Conclusion: Dilated hearts from LVNC benefit more than from myocarditis DCM when exposed to PAB.
Publication History
Article published online:
03 February 2022
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