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[Aneurysms in acute myocardial infarction (multicenter studies)]
O Sczaniecka1, J Kuch, M Srzednicki
1Katedra i Klinika Kardiologii II Wydz. Lek. AM, Warszawie.
Insights
Post-infarction aneurysms occurred in 5.8% of patients following acute myocardial infarction. While ventricular arrhythmias were frequent initially, their incidence decreased similarly in both groups, showing no significant difference between patients with and without aneurysms.
Area of Science:
- Cardiology
- Clinical Medicine
- Medical Research
Background:
- Acute myocardial infarction can lead to serious complications.
- Post-infarction cardiac aneurysm is a recognized but less understood sequela.
- Understanding the clinical course and frequency of these aneurysms is crucial for patient management.
Purpose of the Study:
- To determine the frequency of cardiac aneurysms after acute myocardial infarction.
- To investigate the clinical course and associated factors of post-infarction aneurysms.
- To explore the relationship between aneurysm localization and clinical outcomes.
Main Methods:
- A cohort of 730 patients with acute myocardial infarction was studied.
- Diagnosis of aneurysm was confirmed using echocardiography and other clinical criteria.
- Patients were monitored for arrhythmias and heart failure severity (Killip-Kimball classification).
Main Results:
- Post-infarction aneurysms were identified in 5.8% of patients (42/730).
- Antero-lateral aneurysms were more common (85.7%) than inferior-posterior (14.3%).
- No significant differences in ventricular arrhythmia frequency or heart failure progression were observed between patients with and without aneurysms.
Conclusions:
- The incidence of post-infarction cardiac aneurysms is relatively low.
- Aneurysm localization did not correlate with contractility disturbances or heart failure severity.
- Ventricular arrhythmias and heart failure progression appear independent of aneurysm presence or localization post-myocardial infarction.
Abstract:
The authors present outcomes concerning frequency of appearance and clinical course of aneurysms after acute myocardial infarction. The study population consisted of 730 patients (mean age 54 +/- 9 years) with acute myocardial infarction, including 579 men and 151 women. The diagnosis was based on the following criteria: 1) coronary artery disease history, 2) physical examination, 3) ECG, 4) 2-dimensional echocardiography, 5) biochemical data. Post-infarction aneurysm was revealed in 42 patients (5.8%, 33 men and 9 women); antero-lateral aneurysm--in 36 patients (85.7%), and inferior-posterior aneurysm--in 6 patients (14.3%). Ventricular arrhythmias in the first day of infarction had a high frequency in both groups; with aneurysm--92.9%, without aneurysm--82.2%. The frequency of arrhythmia in 21-st day of infarction decreased similarly in both groups with aneurysm--40.5%, without aneurysm--38.9%. There was no statistically significant difference among both groups. There was no correlation between localisation of aneurysms and degree of contractility disturbances of the heart muscle (dyskinesis, akinesis). Heart failure--class III and IVK (Killip-Kimball classification) occurred in 19.0% of patients with aneurysm and in 10.4% of patients without aneurysm. That was no essential correlation between localisation of aneurysms and advancement of the heart failure.