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[An attempt to estimate the value of myocardial contractility in left ventricular aneurysms]
Insights
This study quantifies the effectiveness of healthy heart muscle in patients with left ventricular aneurysms. Prognosis is linked to the healthy ventricle
Area of Science:
- Cardiology
- Medical Imaging
Context:
- Left ventricular aneurysm (LVA) affects cardiac function.
- Quantifying the impact of non-aneurysmal myocardium is crucial for prognosis.
Purpose:
- To quantify the effectiveness of non-aneurysmal myocardium in patients with left ventricular aneurysms.
- To establish prognostic indicators based on healthy and dyskinetic myocardial function.
Summary:
- Monoplanar angiography was used to measure global and regional left ventricular volumes and ejection fractions in 50 patients with LVA.
- A novel index was developed to assess the impact of dyskinetic zones on overall cardiac function.
- Prognosis was found to correlate with the ejection fraction and end-diastolic volume of the healthy myocardium, adjusted for adjacent dyskinetic zones.
Impact:
- Provides a method to assess the functional contribution of healthy myocardium in LVA.
- Helps determine surgical operability limits for extensive left ventricular aneurysms, particularly in patients with heart failure.
Abstract:
Using monoplanar angiography at 30 degrees, the authors have attempted to quantify the effectiveness of the non-aneurysmal myocardium in 50 patients (17 of them having undergone surgery) with an aneurysm of the left ventricle. Having fixed the position of two points during systole and diastole, they first delimit the aneurysmal zone and/or neighbouring dyskinetic zones in relation to the zones which are still 'healthy'. By a method of integration based on the formula of the three levels, they first measure the global volume of the left ventricle and its ejection fraction, and gain an idea of the size of the aneurysm. They then evaluate the ejection fraction and the volumes of each of the other zones. They have shown that the prognosis depends upon the ejection fraction and the end-diastolic volume of the ventricle which is presumed to be healthy, these measurements being corrected according to the size, expressed as an ejection volume, of the adjacent dyskinetic zone, which can be assessed by an index (volume of the dyskinetic zone as a proportion of the total 'healthy' and dyskinetic zones, in turn expressed as a ratio of the ejection fraction). The application of this work is to be found in seeking a limit of operability for extensive left ventricular aneurysms with cardiac failure.