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Clinical, electrocardiographic, and echocardiographic features in patients with asymptomatic aortic abdominal
R Bolognesi1, G Tiberti, M Azzarone
1Cattedra di Cardiologia, Università degli Studi di Parma, Italy.
Insights
Patients with asymptomatic aortic abdominal aneurysm (AAAA) show high rates of cardiac issues, including left ventricular hypertrophy and conduction disturbances, impacting prognosis.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Cardiac involvement is crucial in peripheral vascular diseases, affecting patient prognosis.
- Asymptomatic aortic abdominal aneurysm (AAAA) patients often have undiagnosed cardiac conditions.
Purpose of the Study:
- To evaluate the cardiac condition in patients with asymptomatic aortic abdominal aneurysm (AAAA).
- To identify cardiac abnormalities and risk factors in this patient group.
Main Methods:
- Clinical examination, electrocardiography (ECG), and echo-Doppler evaluations were performed.
- Seventy-eight patients with AAAA (mean age 69.5 years) were assessed.
- Data included medical history, risk factors, ECG findings, and echocardiographic measurements.
Main Results:
- High prevalence of cardiovascular risk factors: hypertension (61.5%), smoking (67.9%), previous myocardial infarction (25.6%).
- ECG showed left ventricular (LV) hypertrophy (25.6%), conduction disturbances (24.4%).
- Echocardiography revealed increased LV mass index (159 g/m2) and asynergic segments in 31 patients.
Conclusions:
- Patients with AAAA exhibit a high prevalence of atherosclerosis and ischemic heart disease risk factors.
- Elevated LV myocardial mass index suggests cardiac remodeling, despite discrepancies with ECG hypertrophy criteria.
- Moderate prevalence of conduction disturbances warrants further investigation.
Abstract:
Cardiac involvement in peripheral vascular diseases can present interesting patho-physiological aspects and can influence the prognosis. The authors evaluated the cardiac condition of patients with asymptomatic aortic abdominal aneurysm (AAAA) by using clinical, electrocardiographic, and echocardiographic techniques. Seventy-eight patients were studied, 74 men and 4 women, with ages ranging from fifty-five to eighty-one years (mean 69.5 +/- 6.4). All patients were submitted to a complete clinical examination, usual blood tests, a 12-lead resting electrocardiogram, and an echo-Doppler evaluation. Forty-eight subjects (61.5%) were affected by hypertension, 53 (67.9%) were smokers, 25 (32.1%) were alcohol abusers, 39 (50%) had a history of angina pectoris, 20 (25.6%) had had previous myocardial infarction, and 30 (38.5%) were receiving active cardiovascular treatment. All patients except 2, who had chronic atrial fibrillation, manifested sinus rhythm. Electrocardiographic signs of left ventricular (LV) hypertrophy were present in 20 cases (25.6%), intraventricular conduction disturbances in 19 (24.4%), pathological Q waves in 20 (25.6%), and primary repolarization abnormalities in 25 (32.1%). Echocardiography showed a slight increase in left atrial diameter and intraventricular septum thickness (41.5 +/- 4.3 and 12.3 +/- 2 mm respectively). A clearer increase was found in LV mass index (159 +/- 44 g/m2). In 31 patients one or more LV asynergic segments were found. In our patients with AAAA the prevalence of major risk factors for atherosclerosis and ischemic heart disease including previous myocardial infarction was high. Echo-derived LV myocardial mass index was higher than normal even though electrocardiographic criteria for LV hypertrophy did not match echocardiographic data in all subjects. Finally a moderate prevalence of intraventricular conduction disturbances was recorded.