[Prognostic value of two-dimensional echocardiography before aneurysmectomy in anterior aneurysm of the left ventricle].
The prognostic value of echocardiographic apical 4 chamber recordings was assessed retrospectively in 18 patients who underwent left ventricular aneurysmectomy following anterior wall myocardial infarction. After an average follow-up period of 2 years, 7 patients had died or remained in functional Classes III or IV (Group 1) and 11 patients had satisfactory clinical outcomes (Group 2). There were no significant clinical or coronary angiographic differences between the two groups. The left ventricular surface area, transverse diameter and fractional shortening of the surface were also comparable in the two groups. The surface area of the aneurysm was greater in patients in Group 1 (37.4 +/- 11.8 cm2 vs 21.1 +/- 15.8 cm2, p less than 0.05). However, the more discriminating parameters were those related to the non-aneurysmal contractile zones (NACZ). Patients in Group 1 had a smaller relative surface area of the NACZ than those in group 2; 6 of the 7 patients in Group 1 had NACZ of less than 40 per cent of the left ventricle compared with none of the patients in Group 2 (p less than 0.001). In addition, the function of the NACZ was significantly worse in Group 1: surface fractional shortening: 9.6 +/- 10.2% vs 32.6 +/- 8.3% (p less than 0.001); ejection fraction: 20.7 +/- 9.1% vs 41.6 +/- 6.1% (p less than 0.001). All patients in Group 1 and none in Group 2 had ejection fractions of the NACZ of less than 30 per cent. Therefore, the apical 4 chamber view provides valuable prognostic information in patients who are candidates for surgical resection of left ventricular anterior wall aneurysms.
Danchin
N
N
Service de cardiologie A, CHU de Nancy-Brabois.
Serri
A
A
Godenir
J P
JP
Selton-Suty
C
C
Juilliere
Y
Y
Amrein
D
D
Villemot
J P
JP
Cherrier
F
F
D000328:Adult; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
Evaluation du rôle pronostique de l'échocardiographie bidimensionnelle avant anévrismectomie pour anévrisme antérieur du ventricule gauche.