[Verification of the prognostic significance of a left-ventricular aneurysm after a first myocardial infarct].
The prognostic implication of a left ventricular aneurysm after a first myocardial infarction has been assessed on a series of 64 patients (mean age 65 +/- 10 years; 55 males and 9 females) having a diagnosis of a left ventricular aneurysms made by the equilibrium gated radionuclide angiocardiography. The control group was composed by 80 patients (mean age 63 +/- 10 years; 65 males and 15 females) with first myocardial infarction and comparable clinical characteristics but without left ventricular aneurysm. Aneurysm was defined as a ventricular segment in phase with atria in the phase parametric imaging. A left ventricular ejection fraction less than 52% was diagnosed in 83% and in 49% of the patients with and without aneurysm respectively (p less than 0.0005). The study group also showed a higher use of digoxin (39% vs 21%; p less than 0.05) and a higher prevalence of ventricular arrhythmias (31% vs 12%; p less than 0.05). After 36 months, mortality was 34% and 17% in patients with and without left ventricular aneurysm, respectively (p less than 0.05). According to the logistic regression analysis, mortality was predicted by a left ventricular ejection fraction less than 52% (odd ratio = 1.91; confidence limits = 1.03-3.48) while neither left ventricular aneurysm nor any of the remaining variables (age, sex, site of the myocardial infarction, peak filling rate, congestive heart failure, ventricular arrhythmias and their Lown class) could affect survival. In conclusion, a left ventricular aneurysm has no prognostic implication after a first myocardial infarction provided that the patients are stratified for the left ventricular ejection fraction.
Puglielli
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Istituto di Clinica Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma.
Incalzi
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RA
Capparella
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O
Carbonin
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P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D011379:Prognosis
Verifica del significato prognostico dell'aneurisma del ventricolo sinistro dopo un primo infarto miocardico.