[Correlations between arrhythmias and left ventricular function at rest and during stress in patients with postinfarct aneurysm].
The results (clinical, hemodynamic, and angiographic data) of 197 patients with left ventricular anterior wall aneurysm were evaluated at rest and during exercise (bicycle ergometer) 6 months after the acute infarction. Using the technique of digital subtraction angiography, left ventricular volumes were estimated after injection of contrast medium into the pulmonary artery and measuring of pulmonary artery pressure. In 136 patients a programmed right ventricular stimulation was performed additionally. The patients were divided into the following groups: patients with (VT+) and without (VT-) ventricular arrhythmias in history. Group VT- was subdivided in patients with positive (RV+) or negative (RV-) result of right ventricular stimulation. In group VT+ chamber volumes were greater and ejection fraction was smaller than in group VT-. At rest the results of subgroup RV+ were similar to group VT+, but during exercise similar to group RV-. These results show that left ventricular function at rest and during exercise is much more impaired in patients with spontaneous and by stimulation-induced arrhythmias than in patients without these arrhythmias. The conclusions for clinical practice of these findings are not yet clear, concerning, for example, the prophylactic use of antiarrhythmic measurements in patients without spontaneous but with induced arrhythmias. Further investigations (long-term follow-ups of these patients) will be necessary.
Medizinische Klinik B, Universität Düsseldorf.
D
D
Szymanski
M
M
Borggrefe
L
L
Ulbricht
J
J
Jehle
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology*; D002302:Cardiac Output / Q000502:physiology; D017023:Coronary Angiography; D004562:Electrocardiography; D005080:Exercise Test; D006322:Heart Aneurysm / Q000175:diagnosis / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
Zusammenhang zwischen Rhythmusstörungen und linksventrikulärer Funktion in Ruhe und unter Belastung bei Patienten mit postinfarziellem Aneurysma.