The aim of this study was to show hemodynamic and clinical improvement of heart failure after reductive annuloplasty of double (mitral and tricuspid) orifices (RADO) in the treatment of ischemic ...(IDCM) and primary (PDCM) dilated cardiomyopathy.
From November 1986 to July 15, 2002, 341 patients underwent operations for dilated cardiomyopathy. The IDCM group consisted of 231 patients (68%) with a mean ejection fraction (EF) of 23.3%. From July 1991 to July 15, 2002, the 110 patients in the PDCM group (mean EF, 22.9%) underwent such operations.
The postoperative 30-day mortality rate was 5.9% for the entire patient population, 7.3% for the IDCM group, and 2.7% for the PDCM group. Follow-up survival rates were 61.5% +/- 4.0% at 5 years and 38.2% +/- 8.0% at 14 years for the IDCM group and 43.9% +/- 5.6% at 5 years and 21.3% +/- 8.5% at 10 years for the PDCM group.
RADO corrects remodeling of the fibrous skeleton of the heart, changes the spherical geometry of the left ventricle, improves the hemodynamic action of the left and right ventricles, and slows down the progression of heart failure. We recommend the RADO procedure as an important associated procedure in the surgical treatment of IDCM and as a new surgical alternative for treating the early stage of PDCM immediately after the first decompensation.
The novel l- and d-amino acid derivatives of hydroxyurea 5a − o were prepared by aminolysis of N-(1-benzotriazolecarbonyl)amino acid amides 4a − o with hydroxylamine. The hydantoin derivatives 6a − ...e,m,p were synthesized by base-catalyzed cyclization of amides 4, common precursors for 5 and 6. X-ray crystal structure analysis shows that the C5 atom in 6e possesses the S configuration, which is consistent with the configuration of the starting reagent, l-leucine. Among l-amino acid derivatives of hydroxyurea, 5h and 5i inhibited specifically murine leukemia and human T-lymphocytes (IC50 = 10−19 μM) and showed selectivity with respect to normal human fibroblasts (WI 38). d-Amino acid derivatives of hydroxyurea 5m and 5o inhibited the growth of all tumor cell lines (IC50 = 4.8−83.9 μM), but not the growth of normal fibroblasts (WI 38; IC50 > 100 μM). Results on antiviral evaluations showed that N-(1-benzotriazolecarbonyl)amino acid amide 4m and hydantoin 6m had marked activity against the Davis strain of CMV (4m, EC50 = 3.2 μg/mL; 6m, EC50 = 4.0 μg/mL). However, these compounds showed also rather expressed cytotoxicity (4m, CC50 = 43.4 μg/mL; 6m, CC50 = 12.5 μg/mL-1).
