Left ventricular apical aneurysm associated with normal coronary arteries following cardiac surgery: Echocardiographic features and differential diagnosis

Xie, Mingxing; Zhou, Hua; Cheng, Tsung O.; Wang, Jing; Wang, Xinfang; Lü, Qing; Yang, Yali; Shi, B.; Fu, Qingmei

doi:10.1016/j.ijcard.2013.06.001

Cited by 10 publications

(5 citation statements)

References 46 publications

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“…Echocardiography stands as the primary non-invasive diagnostic tool for AMI patients, playing an essential role in evaluating mechanical complications, hemodynamics, and overall cardiac function [ 36 – 39 ]. Moreover, myocardial contrast echocardiography (MCE) employs contrast agents to illuminate infarcted areas, further facilitating the detection of ventricular aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Exploratory analysis of predictors of ventricular aneurysm in a cohort of 291 patients with acute myocardial infarction

Huang,

Xu,

Qiang

et al. 2024

BMC Cardiovasc Disord

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Objective In this study, we explored the determinants of ventricular aneurysm development following acute myocardial infarction (AMI), thereby prompting timely interventions to enhance patient prognosis. Methods In this retrospective cohort analysis, we evaluated 297 AMI patients admitted to the First People’s Hospital of Changzhou. The study was structured as follows. Comprehensive baseline data collection included hematological evaluations, ECG, echocardiography, and coronary angiography upon admission. Within 3 months post-AMI, cardiac ultrasounds were administered to detect ventricular aneurysm development. Univariate and multivariate logistic regression analysis were employed to pinpoint the determinants of ventricular aneurysm formation. Subsequently, a predictive model was formulated for ventricular aneurysm post-AMI. Moreover, the diagnostic efficacy of this model was appraised using the ROC curves. Results In our analysis of 291 AMI patients, spanning an age range of 32–91 years, 247 were male (84.9%). At the conclusion of a 3-month observational period, the cohort bifurcated into two subsets: 278 patients without ventricular aneurysm and 13 with evident ventricular aneurysm. Distinguishing features of the ventricular aneurysm subgroup were markedly higher values for age, B-type natriuretic peptide(BNP), Left atrium(LA), Left ventricular end-diastolic dimension (LEVDD), left ventricular end systolic diameter (LVEWD), E-wave velocity (E), Left atrial volume (LAV), E/A ratio (E/A), E/e ratio (E/e), ECG with elevated adjacent four leads(4 ST-Elevation), and anterior wall myocardial infarction(AWMI) compared to their counterparts (p < 0.05). Among the singular predictive factors, total cholesterol (TC) emerged as the most significant predictor for ventricular aneurysm development, exhibiting an AUC of 0.704. However, upon crafting a multifactorial model that incorporated gender, TC, an elevated ST-segment in adjacent four leads, and anterior wall infarction, its diagnostic capability: notably surpassed that of the standalone TC, yielding an AUC of 0.883 (z = -9.405, p = 0.000) as opposed to 0.704. Multivariate predictive model included gender, total cholesterol, ST elevation in 4 adjacent leads, anterior myocardial infarction, the multivariate predictive model showed better diagnostic efficacy than single factor index TC (AUC: 0. 883 vs. 0.704,z =-9.405, p = 0.000), it also improved predictive power for correctly reclassifying ventricular aneurysm occurrence in patients with AMI, NRI = 28.42% (95% CI: 6.29-50.55%; p = 0.012). Decision curve analysis showed that the use of combination model had a positive net benefit. Conclusion Lipid combined with ECG model after myocardial infarction could be used to predict the formation of ventricular aneurysm and aimed to optimize and adjust treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Exploratory analysis of predictors of ventricular aneurysm in a cohort of 291 patients with acute myocardial infarction

Huang,

Xu,

Qiang

et al. 2024

BMC Cardiovasc Disord

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“…Echocardiography is the preferred diagnostic method for left ventricular aneurysms after cardiac events. 1 The aneurysm's thin‐walled dyskinetic or akinetic segments may be composed of dense scars with viable myocardium channels. It may be the site of origin for ventricular tachycardia.…”

Section: Diagnosismentioning

confidence: 99%

“…Coronary artery disease is the most common cause of left ventricular aneurysms. Echocardiography is the preferred diagnostic method for left ventricular aneurysms after cardiac events 1 . The aneurysm's thin‐walled dyskinetic or akinetic segments may be composed of dense scars with viable myocardium channels.…”

Section: Diagnosismentioning

confidence: 99%

Man with chest tightness and diaphoresis

2023

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“…It is defined as an area of the ventricular myocardium with a thinner myocardium of the adjacent wall that manifests akinesia or dyskinesia and that affects the entire thickness of the wall. The location of an LVA in up to 80% of cases is the antero-apical wall associated with obstruction of anterior descending artery [1]. Survival to 3 and 5 years is 27% and 12%, respectively, with appropriate surgical treatment survival to 5 years increases to 71% [2].…”

Section: Introductionmentioning

confidence: 99%

Multi-Image Studies of Atypical Location of Ventricular Aneurysms and Survival: Clinical Cases Series

Camacho-Camacho¹,

Carvajal-Juárez²,

Guatibonza-Zambrano³

et al. 2019

WJCD

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Background: A left ventricular aneurysm is a mechanical complication of a myocardial infarction that frequently develops on the anterior and apical wall. Survival of 3 to 5 years is 27% and 12%, respectively. Our objective is to report 3 cases of ventricular aneurysms in atypical locations and analyze the survival of these patients. Material and Methods: Three patients with suspicion of ventricular aneurysm after acute myocardial infarction who sought attention at our institution were included. All underwent transthoracic echocardiograms (TTE), cardiac magnetic resonance (CMR), nuclear cardiology (NC), coronary angiotomography and cardiac catheterization to assess the location and characteristics of the aneurysms, left ventricular systolic function and the anatomical and functional condition of the coronary arteries. Results: The mean age of studied patients was 58.33 ± 10.37 years. The locations of the ventricular aneurysms were lateral, inferior and septal. The patients received optimal medical treatment to control heart failure and were discharged in stable condition without early mortality. The mean follow-up was 6.33 years (intervals: 2 -9) and during this period the patients were in NYHA functional class I/II. Conclusion: Left ventricular aneurysm is a late mechanical complication of an infarction that can develop in an atypical location. Diagnosis is achieved using non-invasive techniques such as TTE, CMR, NC, and coronary angiotomography. No mortality occurred among the patients during medium and long-term follow-up.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard. This study was approved by the Ethical Committee of our institution.

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Left ventricular apical aneurysm associated with normal coronary arteries following cardiac surgery: Echocardiographic features and differential diagnosis

Cited by 10 publications

References 46 publications

Exploratory analysis of predictors of ventricular aneurysm in a cohort of 291 patients with acute myocardial infarction

Exploratory analysis of predictors of ventricular aneurysm in a cohort of 291 patients with acute myocardial infarction

Man with chest tightness and diaphoresis

Multi-Image Studies of Atypical Location of Ventricular Aneurysms and Survival: Clinical Cases Series

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