Related Experiment Videos
Postinfarction left-ventricular aneurysm: regional stress, function, and remodeling after aneurysmectomy
K Taniguchi1, M Sakurai, T Takahashi
1First Department of Surgery, Osaka University Medical School, Japan.
The Thoracic and Cardiovascular Surgeon
|January 13, 1999
Summary
Left-ventricular aneurysmectomy (LVA) improves ejection fraction and reduces wall stress in noninfarcted heart segments after myocardial infarction (MI). This surgery may favorably impact left-ventricular remodeling post-MI.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Research
Background:
- Left-ventricular (LV) aneurysm after myocardial infarction (MI) causes cardiac dysfunction.
- LV aneurysmectomy (LVA) may improve function, but its effects on regional wall stress and systolic function in noninfarcted areas are unclear.
Purpose of the Study:
- To assess LVA's impact on regional stress and systolic function in noninfarcted segments.
- To examine LVA's effect on LV remodeling in patients with LV aneurysm post-MI.
Main Methods:
- Quantitative left ventriculography and pressure measurements in 11 LVA patients and 10 coronary artery bypass grafting (CABG) control patients.
- Regional end-systolic (ESS) and end-diastolic (EDS) stresses of contractile segments (CS) computed using Janz's method.
- Comparison of pre-operative and 8-month post-operative data.
Main Results:
- LVA group showed increased ejection fraction (EF) and mean velocity of circumferential fiber shortening (mean Vcf) (p < 0.01).
- LVA decreased end-diastolic and end-systolic volume indices (p < 0.01) and regional ESS/EDS (p < 0.01/p < 0.05) in CS.
- Increased mean Vcf correlated with decreased ESS in the LVA group (r = -0.63, p < 0.01).
Conclusions:
- LVA reduces regional afterload and enhances ejection performance of noninfarcted myocardium.
- LVA may favorably influence LV remodeling following myocardial infarction.