Comparative Analysis of Basal vs. Apical Left Ventricular Aneurysms: Impact on Ejection Fraction and Cardiac Function

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Cardiac Surgery

Background:

• Left ventricular aneurysm (LVA) is linked to reduced cardiac function and ejection fraction (EF) due to non-functional myocardium.
• Left ventricular end-diastolic volume (LVEDV), left ventricular aneurysm volume (LVAV), and their ratio correlate with EF.

Purpose of the Study:

• Characterize left ventricular aneurysms (LVA) post-myocardial infarction (basal vs. apical).
• Evaluate the impact of aneurysm volume and area (diastole and systole) and their ratios with left ventricular volumes/areas on EF.
• Identify critical predictive factors for managing the impact of aneurysms on cardiac function.

Main Methods:

• Observational study of post-infarction LVA patients using transthoracic echocardiography.
• Area-length method to assess ventricular and aneurysm volumes/areas (LVEDV, LVESV, LVAVd, LVAVs, LVAAd, LVAAs, LVEDA, LVESA).
• Simpson's method for EF calculation; derived ratios (LVAVd/LVEDV, etc.).

Main Results:

• Basal aneurysms were significantly smaller in LVAVd, LVAAd, and LVAAs compared to apical aneurysms.
• No significant difference in EF or overall LV volumes between basal and apical LVA groups.
• LVAVd showed the strongest negative correlation with EF (-0.695), followed by LVAVd/LVEDV ratio (-0.637).

Conclusions:

• Basal aneurysms are smaller, but EF and LV volumes are similar between basal and apical LVA groups.
• LVAVd has the most substantial negative impact on systolic function (EF).
• The LVAVd/LVEDV ratio is also a significant predictor of reduced EF in LVA patients.