The use of hemosorption in patients with dilated cardiomyopathy and severe heart failure as an alternative to surgical left ventricular remodeling

Abstract

Background. Currently, about 40 million people in the world suffer from heart failure (HF). The development of severe HF is most often caused by dilated cardiomyopathy (DCM) that is a frequent indication for heart transplantation worldwide. Despite significant advances in the medical treatment of this pathology, the morbidity, hospitalization rates, and mortality are constantly increasing. This study aimed to evaluate the effectiveness of hemosorption in patients with severe HF on the background of DCM compared to surgical left ventricular remodeling. Materials and methods. The study is based on the results of a retrospective study that included 80 patients with severe HF on the background of DCM (NYHA III–IV). In group 1 (59 patients; left ventricular ejection fraction (LVEF) 21.10 ± 4.66 %), conservative medical therapy was supplemented with a course of 3 hemosorption procedures using granular deligandizing hemosorbent. In group 2 (21 patients; LVEF 22.40 ± 2.27 %), patients underwent surgical interventions in the form of LV remodeling. Results. There was a significant improvement in the clinical state and LV contractility in both groups. In group 1, LVEF increased by 12.90 ± 2.06 % (p < 0.01), in group 2 — by 13.25 ± 2.98 % (p < 0.05). Howe­ver, more complications, longer hospital stay, and higher morta­lity were associated with LV remodeling. Conclusions. The use of extracorporeal hemocorrection methods in the comprehensive treatment of patients with DCM can improve the clinical state of patients, treatment outcomes and avoid the risks associated with surgical interventions.