Pre- and Postoperative Assessment of Left Ventricular Function by Magnetic Resonance Imaging and 2-D-Echocardiography in Patients Undergoing Left Ventricular Aneurysmectomy
| Autor: | T. Dill, G. Bachmann, W. Ricken, Z Szalay, R. R. Brandt, C. Breidenbach, A. John, Christian W. Hamm, O. Ekinci, Erwin P. Bauer |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Heart Ventricles Ventricular Function Left Aneurysm Ventricular aneurysmectomy Internal medicine medicine Humans In patient Heart Aneurysm Aged Ultrasonography Aged 80 and over Lv function Ejection fraction medicine.diagnostic_test Ventricular function business.industry Magnetic resonance imaging Stroke volume Middle Aged medicine.disease Magnetic Resonance Imaging Cardiology Female Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 52:274-279 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-2004-821077 |
| Popis: | BACKGROUND Left ventricular (LV) aneurysms may complicate myocardial infarctions. Reliable quantification of LV functional parameters is mandatory to predict clinical outcome in patients undergoing LV aneurysmectomy. We compared global LV function measured by magnetic resonance (MR) and 2-D-echocardiography in patients before and after aneurysmectomy. METHODS 31 patients (23 male), mean age 64 (range 35 - 85) years with an LV aneurysm (25/31 anterior MI, 5/31 inferior MI, 1/31 both) were enrolled. MR and echocardiography were performed directly before and 3 - 65 (median 8) days after surgery. MR studies were performed on a 1.5 Tesla scanner. End-diastolic and end-systolic volumes and diameters (EDV/ESV, EDD/ESD), ejection fraction (EF) and stroke volume (SV) were determined. Echocardiography was performed to determine EF, EDD and ESD. NYHA class was assessed before and 3 months after surgery. RESULTS After aneurysmectomy MR analysis showed a decrease in EDV (255 +/- 68 ml to 202 +/- 59 ml) ( p < 0.001) and ESV (186 +/- 71 ml to 134 +/- 53 ml; p < 0.001); EF increased (28 +/- 10 % to 35 +/- 12 %; p < 0.001); EDD/ESD decreased ( p < 0.01). Compared to echocardiography, a low correlation was found in EF before/after surgery r = 0.76/r = 0.69 and ESD r = 0.43/r = 0.60, respectively. In EDD a good correlation was found before surgery (r = 0.81), and a lower correlation after surgery (r = 0.72). NYHA class improved from 3.0 +/- 0.5 before to 1.8 +/- 0.8 after operation ( p < 0.001). CONCLUSION Resection of an LV aneurysm results in a mean improvement of 25 % in LV function, and improved clinical outcome. In asymmetric ventricles with aneurysms MR proved to be superior as a sensitive and non-invasive tool compared to conventional 2-D-echocardiography. |
| Databáze: | OpenAIRE |
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