Right ventricular aneurysm: a new prognostic indicator after a first acute myocardial infarction.
The prognostic implication of a right ventricular aneurysm after a first acute myocardial infarction (AMI) was assessed on a series of 137 AMI patients 12 of whom had a right ventricular aneurysm detected at radionuclide angiocardiography. The follow-up lasted 36 months. Mortality was 50 and 18.4% in patients with and without right ventricular aneurysm, respectively (p less than 0.02). Groups did not differ in age, male-to-female ratio, AMI site, left ventricular ejection fraction (LVEF), peak filling rate (PFR), left ventricular size. A multivariate logistic analysis showed that only three out of ten clinical and functional variables qualified to be independent predictors of death: right ventricular aneurysm (odd ratio = 2.48, confidence limits = 1.21-4.98), LVEF less than 52% (odd ratio = 1.91, confidence limits = 1.03-3.48), abnormal terminal P wave forces (odd ratio = 1.72, confidence limits = 1.07-2.75). The analysis of single case histories did not provide a clue to clarify the reasons accounting for the negative prognostic implication of a right ventricular aneurysm. In conclusion, a significant positive relationship between right ventricular aneurysm and mortality after AMI has been demonstrated; further study is needed to clarify the relevant mechanisms.
Antonelli Incalzi
R
R
Istituto di Clinica Medica, Università Cattolica del Sacro Cuore, Roma, Italia.
Capparella
O
O
Gemma
A
A
Puglielli
L
L
Bonetti
M G
MG
Carbonin
P
P
D000368:Aged; D004562:Electrocardiography; D005260:Female; D006322:Heart Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D016017:Odds Ratio; D011379:Prognosis; D011875:Radionuclide Angiography; D012044:Regression Analysis; D013318:Stroke Volume