INCIDENCE, TIMING AND PROGNOSTIC VALUE OF LEFT-VENTRICULAR ANEURYSM FORMATION AFTER MYOCARDIAL-INFARCTION - A PROSPECTIVE, SERIAL ECHOCARDIOGRAPHIC STUDY OF 158 PATIENTS
INCIDENCE, TIMING AND PROGNOSTIC VALUE OF LEFT-VENTRICULAR ANEURYSM FORMATION AFTER MYOCARDIAL-INFARCTION - A PROSPECTIVE, SERIAL ECHOCARDIOGRAPHIC STUDY OF 158 PATIENTS
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DOI：
10.1016/0002-9149(86)90603-x
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发表时间：
1986-04-01
影响因子：
2.8
通讯作者：
DEKONING, H
中科院分区：
文献类型：
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作者：
VISSER, CA;KAN, G;DEKONING, H
对158例首次急性心肌梗死（AMI）的连续患者前瞻性地进行了系列二维超声心动图检查，以确定左心室（LV）动脉瘤形成的发生率和LV动脉瘤形成所需的时间过程及其临床意义。在前5天以及3个月和1年后进行研究。LV动脉瘤定义为收缩期和舒张期LV轮廓的异常隆起。超声心动图诊断前壁AMI 84例，后壁AMI 68例，前后壁AMI 6例。在研究期间，158例患者中有35例（22%）发现左室动脉瘤：前壁AMI 27例，后壁AMI 6例，前后壁AMI 2例。3个月后没有新的动脉瘤发生。15例前壁梗死患者在AMI后5天内出现早期动脉瘤形成。15例患者中有12例（80%）在1年内死亡（10例在3个月内死亡），而其余20例左室动脉瘤患者中有5例（25%）死亡（p < 0.05）。急性期前壁运动障碍常导致动脉瘤形成。因此，左室动脉瘤形成见于22%的前壁AMI，并发生在AMI后3个月内。早期动脉瘤形成与3个月（67%）和1年（80%）的高死亡率相关。
Serial 2-dimensional echocardiography was performed prospectively in 158 consecutive patients with first acute myocardial infarction (AMI) to determine the incidence of left ventricular (LV) aneurysm formation and the time course required for, and the clinical significance of, onset of LV aneurysm formation. Studies were performed throughout the first 5 days and after 3 months and 1 year. LV aneurysm was defined as an abnormal bulge in the LV contour during both systole and diastole. Eighty-four patients had anterior, 68 posterior and 6 anteroposterior AMI defined echocardiographically. During the study period, LV aneurysm was found in 35 of 158 patients (22%): in anterior AMI in 27, in posterior AMI in 6 and in anteroposterior AMI in 2. No new aneurysm developed after 3 months. Early aneurysm formation, during the first 5 days after AMI, was seen in 15 patients with anterior infarction. Twelve of these 15 (80%) died within 1 year (10 within 3 months), in contrast to 5 (25%) of the remaining 20 patients with LV aneurysm (p < 0.05). Dyskinesia of the anterior wall in the acute stage usually resulted in aneurysm formation. Thus, LV aneurysm formation is seen in 22% of mostly anterior AMI and occurs within 3 months after AMI. Early aneurysm formation is associated with a high 3-month (67%) and 1-year (80%) mortality rate.