[Effects of left ventricular reconstruction on magnetic resonance imaging derived left ventricular wall stress and contractive function in patients with postinfarction ventricular aneurysm].
OBJECTIVE
To evaluate the effects of left ventricular reconstruction on left ventricular wall stress and function in patients with postinfarction left ventricular aneurysm.


METHODS
During January 2005 to June 2006, 16 patients [15 male, (56.6 +/- 8.8) years] with postinfarction ventricular aneurysm received left ventricular reconstruction operation on CPB (5 linear repair, 6 endoventricular purse-string suture, 5 endoventricular patch repair) and CABG was also performed in 15 patients. MRI examination was made before and 3 months post operation by Siemens Magnetom Avanto 1.5T MR with routine cine-MRI in combination with late-delayed enhancement sequence. Left ventricular geometric parameters and segmental thickening were obtained with accessory image analysis software. Non-invasive blood pressure was acquired in order to compute ventricular wall stress. The revascularized and unrevascularized segments were defined by comparing the post operation revascularization of the blood-supply coronary artery with preoperative results.


RESULTS
A total of 192 segments including 74 unrevascularized segments were analyzed. Segmental thickening were significantly increased while wall stress were significantly reduced in both unrevascularized and revascularized segments 3 months post operation compared to preoperative values (all P < 0.05). The increase of wall thickening was positively correlated with the reduction of wall stress in these segments.


CONCLUSIONS
Left ventricular reconstruction plus CABG is associated with reduced left ventricular wall stress and increased myocardial contractive function in patients with postinfarction left ventricular aneurysm.
Fan
Hong-Guang
HG
Department of Cardiac Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Feng
Wei
W
Zheng
Zhe
Z
Zhang
Yan
Y
Zhao
Shi-Hua
SH
Hu
Sheng-Shou
SS
D000368:Aged; D005260:Female; D006322:Heart Aneurysm / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling