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[Long-term prognosis in patients with chronic postinfarct aneurysms. I. Conservative treatment of patients]
Insights
This study tracked 99 patients with left ventricular aneurysm (LVA), finding congestive heart failure (CHF) common. Key predictors of survival included heart failure severity and specific cardiac function measurements.
Area of Science:
- Cardiology
- Cardiac Surgery
- Heart Failure Research
Context:
- Left ventricular aneurysm (LVA) is a serious cardiac condition.
- Congestive heart failure (CHF) is a common complication of LVA.
- Understanding the natural history of LVA is crucial for patient management.
Purpose:
- To investigate the natural history and survival outcomes of patients with angiographically defined left ventricular aneurysm (LVA).
- To identify predictors of mortality in patients with LVA.
- To define high-risk subgroups within the LVA patient population.
Summary:
- A study followed 99 patients with LVA, with CHF affecting 52.5%. Mean follow-up was 94 months.
- Cumulative survival rates at 1, 5, 7, and 10 years were 92%, 65%, 60%, and 28%, respectively.
- High-risk factors identified include elevated left ventricular end-diastolic pressure (LVEDP > 3.3 kPa), low contractile segment ejection fraction (CSEF < 40%), low ejection fraction (EF < 20%), and extensive LVA (>40% of diastolic area). Cox analysis revealed CHF impairment, LVEDP, LVEDVI, and diseased vessels as significant outcome predictors.
Impact:
- Provides critical data on the long-term prognosis of left ventricular aneurysm.
- Identifies specific clinical and hemodynamic parameters that predict poor outcomes.
- Informs clinical decision-making and risk stratification for patients with LVA and associated heart failure.
Abstract:
Natural history of 99 patients with angiographically defined left ventricular aneurysm (LVA) has been studied. Congestive heart failure (CHF) was predominant in 52.5% patients. Mean follow-up was 94 months. The cumulative survival at 1, 5, 7, 10 years were 92, 65, 60 and 28% respectively. Left ventricular end-diastolic pressure averaged 2.8 kPa (LVEDP), ejection fraction (EF) 31%, contractile segment ejection fraction (CSEF) 45%, stroke work 6.7 mj. g-1, diastolic compliance 0.36 kPa-1 and passive elastic modulus 64.1 kPa. High risk groups of patients were those with LVEDP more than 3.3 kPa, CSEF less then 40%, EF less then 20% and with extent of LVA more then 40% of the diastolic area of the left ventricle. The Cox analysis of survival indicated following variables predicted outcome: functional impairment due to CHF, LVEDP, LVEDVI and number of vessels diseased.