M-mode echocardiography in the detection of surgically resectable left ventricular aneurysm.
Thirty-nine patients with severe cardiac failure and a previous transmural myocardial infarct were studied prospectively to assess the ability of M-mode echocardiography to detect resectable left ventricular aneurysms. Subsequent angiography showed an aneurysm in 23 patients and diffuse left ventricular damage in 16. Nine (57%) of the patients without aneurysm had either left ventricular end-systolic dimensions in excess of 6 cm combined with reduced contraction of the base of the left ventricle (fractional shortening of the level of the mitral valve less than 20%), or gross reduction of contraction (fractional shortening less than 15%) regardless of left ventricular dimension. These abnormalities did not occur in any patient with an aneurysm. In 21 (91%) of the patients with a left ventricular aneurysm its presence was correctly predicted either by fractional shortening in excess of 20% (16 patients) or gross delay of mitral valve opening (greater than 80 ms 16 patients). In one patient without an aneurysm, fractional shortening was greater than 20% and thus incorrectly suggested the presence of aneurysm. Only 39% of aneurysms were directly visualized. Therefore M-mode echocardiography can correctly rule out the diagnosis in over 50% of patients without an aneurysm and strongly suggest the possibility in over 90% of patients with one.
D000328:Adult; D000368:Aged; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D009200:Myocardial Contraction; D013902:Radiography, Thoracic