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European Heart Journal 1990 11(5):441-446;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Does left ventricular aneurysm influence survival after acute myocardial infarction?

M. HERAS*, G. SANZ, A. BETRIU, L. MONT, T. DE FLORES and F. NAVARRO-LOPEZ

Cardiovascular Division, Department of Medicine, Hospital Clinic i Provincial, University of Barcelona Spain

Received 3 January 1989; revised 10 August 1989; .

*Address fpr reprints: Magda Heras, M.D., cardiovascular Division, Hospital Clinic I Provincial, Villarroel 170, Barcelona 08036, Spain.

Abstract

To test whether left ventricular aneurysm independently influences survival after acute myocardial infarction, a series of 386 consecutive men aged60 years or less, were followed up for 57(40–100) months. Catheterization was performed 1 month following the infarct. Aneurysm, defined as a diastolic outward bulging with akinetic or dyskinetic systolic motion, was diagnosed in 52 patients (13–5%). Mortality was higher (29% vs 14% P < 0–02) in patients with left ventricular aneurysm; their probability of survival at 60 months was 75%vs90% in patients without aneurysm. Cox regression analysis for the whole population identified ejection fraction, bifascicular block, number of diseased vessels and angina after infarction as the only independent predictors of survival; when adjusted for these variables, differences in mortality between patients with and without aneurysm were no longer significant.

To investigate further the role of aneurysm in survival, the 52 patients presenting with left ventricular aneurysm were matched with 52 of the remaining 334 patients according to the following baseline variables: ejection fraction, number of diseased vessels, left ventricular end-diastolic pressure, and bifascicular block. The survival curves of these two subsets were similar (mortality rates of 75% and 82%, respectively). Cox regression analysis of the whole cohort of 104 patients selected bifascicular block and the number of diseased vessels, but not left ventricular aneurysm, as independent predictors of outcome.

Key Words: Left ventricular aneurysm • postinfarct prognosis


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