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Natural history of chronic left ventricular aneurysm; a population based cohort study

R Benediktsson1, O Eyjolfsson, G Thorgeirsson

  • 1Department of Medicine, National University Hospital, Reykjavik, Iceland.

Journal of Clinical Epidemiology
|January 1, 1991
PubMed

Insights

Chronic left ventricular aneurysm patients had reduced survival, but this was linked to more extensive myocardial damage, not the aneurysm itself. Further analysis showed similar survival rates when myocardial damage was considered.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Clinical Epidemiology

Background:

  • Chronic left ventricular aneurysm is a significant clinical concern.
  • Understanding its impact on morbidity and mortality is crucial for patient management.
  • Previous studies may not have fully accounted for confounding factors like myocardial damage.

Purpose of the Study:

  • To evaluate the morbidity and mortality associated with chronic left ventricular aneurysm.
  • To compare survival rates between patients with left ventricular aneurysm and a control group.
  • To determine if the aneurysm itself or the extent of myocardial damage influences survival.

Main Methods:

  • A population-based cohort study utilizing cardiac catheterization data from Iceland (1983-1985).
  • Inclusion criteria defined left ventricular aneurysm based on diastolic contour and systolic wall motion abnormalities.
  • A control group with akinetic segments but normal diastolic contour was selected for comparison.

Main Results:

  • The left ventricular aneurysm group had a significantly lower mean ejection fraction (46% vs 56%).
  • Collateral circulation was more frequent in the control group (88% vs 72%).
  • Initially, the aneurysm group showed higher mortality (19 vs 12 deaths), but this difference became non-significant after adjusting for myocardial damage extent.

Conclusions:

  • Reduced survival in left ventricular aneurysm patients is primarily attributed to more extensive myocardial damage.
  • The presence of an aneurysm per se does not appear to be an independent predictor of mortality.
  • Clinical assessment should consider the extent of myocardial damage alongside aneurysm presence.

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