Department of Cardiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Neth Heart J. 2009 Dec;17(12):475-80. doi: 10.1007/BF03086307.
Background. Left ventricular aneurysm (LVA) in patients with idiopathic dilated cardiomyopathy (IDCM) is rarely reported, and the incidence, pathogenesis and clinical features of LVA in IDCM are poorly understood.Methods. The diagnosis of IDCM with LVA formation was made in six patients between January 2003 and September 2008. Left ventriculography, coronary angiography, echocardiogram and electrocardiogram were performed in all patients. The hospital records of these patients with IDCM in our hospital and related literature were reviewed.Results. LVA was located at the posterobasal wall in five patients and at the anterolateral wall in one patient. Two patients had abnormal Q waves and no patients had sustained ST-segment elevation on electrocardiogram. No significant coronary stenosis or mural thrombi was detected in these patients. All patients had severe ventricular arrhythmia, such as frequent multifocal ventricular premature contractions and ventricular tachycardia.Conclusion. IDCM could be a rare cause of LVA. The LVA in IDCM was mainly located at the posterobasal wall. It was seldom accompanied by abnormal Q waves and sustained ST-segment elevation. The pathogenesis of LVA in IDCM seems to be less likely to be related to coronary emboli. Ventricular arrhythmia occurred frequently in these patients. (Neth Heart J 2009;17:475-80.).
特发性扩张型心肌病（IDCM）患者中的左心室瘤（LVA）很少见，其发病率、发病机制和临床特征尚不清楚。
在 2003 年 1 月至 2008 年 9 月期间，我们诊断了 6 例形成 LVA 的 IDCM 患者。所有患者均进行了左心室造影、冠状动脉造影、超声心动图和心电图检查。回顾了我院这些 IDCM 患者的住院病历和相关文献。
5 例患者的 LVA 位于后基底壁，1 例患者位于前外侧壁。2 例患者心电图有异常 Q 波，但无患者出现持续 ST 段抬高。这些患者无明显冠状动脉狭窄或壁内血栓形成。所有患者均有严重的室性心律失常，如频发多灶性室性早搏和室性心动过速。
IDCM 可能是 LVA 的罕见病因。IDCM 中的 LVA 主要位于后基底壁。很少伴有异常 Q 波和持续 ST 段抬高。IDCM 中 LVA 的发病机制似乎不太可能与冠状动脉栓塞有关。这些患者常发生室性心律失常。（Neth Heart J 2009;17:475-80.）。
