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Effect of left ventricular aneurysm on risk of sudden and nonsudden cardiac death

C A Hassapoyannes1, L M Stuck, C A Hornung

  • 1Department of Medicine, University of South Carolina School of Medicine, Columbia 29201.

The American Journal of Cardiology
|March 1, 1991
PubMed

Insights

Left ventricular aneurysm, a complication of myocardial infarction, independently predicts sudden cardiac death. Risk factors for cardiac death differ between aneurysm and non-aneurysm patients post-MI, highlighting Holter monitoring

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Internal Medicine

Background:

  • Left ventricular (LV) aneurysm following myocardial infarction (MI) is linked to higher mortality, but its independent prognostic value remains debated.
  • Understanding the specific risks associated with LV aneurysm is crucial for patient management and risk stratification after MI.

Purpose of the Study:

  • To investigate the independent prognostic significance of LV aneurysm on mortality after healed myocardial infarction.
  • To compare risk profiles for cardiac death between patients with and without LV aneurysm.
  • To identify predictors of sudden and nonsudden cardiac death in these patient groups.

Main Methods:

  • A cohort of 121 patients with healed MI was divided into an MI group (n=55, akinesia) and an LV aneurysm group (n=66, diastolic deformity and systolic dyskinesia).
  • Patients were followed for a mean of 5.7 years, with outcomes including total cardiac death, nonsudden cardiac death, and sudden cardiac death recorded.
  • Multivariate analysis was used to identify independent predictors of mortality, with ejection fraction, revascularization, coronary artery disease, Holter monitoring, and ventricular arrhythmias as key variables.

Main Results:

  • LV aneurysm was an independent predictor of late sudden cardiac death after MI.
  • Decreasing ejection fraction was the best predictor of total cardiac death; revascularization showed a protective effect.
  • In the LV aneurysm group, ventricular tachycardia was the sole predictor of sudden cardiac death, while ejection fraction, ventricular tachycardia, and right coronary artery disease predicted nonsudden cardiac death.

Conclusions:

  • LV aneurysm is an independent predictor of sudden cardiac death following myocardial infarction.
  • Risk stratification for cardiac death differs between patients with LV aneurysm and those with simple MI.
  • Holter monitoring is valuable for identifying patients at persistent risk of sudden cardiac death, particularly in the presence of LV aneurysm.

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