Cardiovascular Institute "Dedinje", 11040 Belgrade, Serbia.
Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina.
Medicina (Kaunas). 2024 Jul 16;60(7):1141. doi: 10.3390/medicina60071141.
. Distinct pressure curve differences exist between akinetic (A-LVA) and dyskinetic (D-LVA) aneurysms. In D-LVA, left ventricular (LV) ejection pressure decreases relative to the aneurysm size, whereas A-LVA does not impact pressure curves, indicating that the decrease in stroke volume (SV) and cardiac output is proportional to the size of dyskinesia. This study aimed to assess the frequency of A-LVA and D-LVA, determine aneurysm size parameters (volume and surface area), and evaluate predictive parameters using echocardiography in A-LVA and D-LVA. Furthermore, it aimed to compare individual echocardiographic parameters, according to ejection fraction (EF) and SV, with hemodynamic events shown in experimental models of A-LVA and D-LVA and their significance in everyday clinical practice. . This clinical study included patients with post-infarction left ventricular aneurysm (LVA) admitted to the cardiovascular institute ''Dedinje", Serbia. Echocardiographic volume and surface area of LV and LVA were determined (by the area-length method) along with EF (by Simpson's method). . A-LVA was present in 62.9% of patients, while D-LVA was present in 37.1%. Patients with D-LVA had significantly higher systolic aneurysm volume (LVAVs) (94.07 ± 74.66 vs. 51.54 ± 53.09, = 0.009), systolic aneurysm surface area (LVAAs) (23.22 ± 11.73 vs. 16.41 ± 8.58, = 0.018), and end-systolic left ventricular surface areas (LVESA) (50.79 ± 13.33 vs. 42.76 ± 14.11, = 0.045) compared to patients with A-LVA. The ratio of LVA volume to LV volume was higher in the D-LVA in systole (LVAVs/LVESV). The end-diastolic volume of LV (LVEDV) and end-systolic volume of LV (LVESV) did not significantly differ between D-LVA and A-LVA. EF (21.25 ± 11.92 vs. 28.18 ± 11.91, = 0.044) was significantly lower among patients with D-LVA. . Differentiating between A-LVA and D-LVA using echocardiography is crucial since D-LVA causes greater hemodynamic disturbances in LV function, and thus surgical resection of the aneurysm or LV reconstruction must have a positive effect regardless of myocardial revascularization surgery.
. 无运动（A-LVA）和运动障碍（D-LVA）动脉瘤之间存在明显的压力曲线差异。在 D-LVA 中，左心室（LV）射血压力相对于动脉瘤大小降低，而 A-LVA 不会影响压力曲线，表明每搏输出量（SV）和心输出量的减少与运动障碍的大小成正比。本研究旨在评估 A-LVA 和 D-LVA 的频率，确定动脉瘤大小参数（体积和表面积），并使用超声心动图评估 A-LVA 和 D-LVA 中的预测参数。此外，根据射血分数（EF）和 SV，比较个体超声心动图参数，与 A-LVA 和 D-LVA 的实验模型中显示的血流动力学事件及其在日常临床实践中的意义。. 本临床研究纳入了塞尔维亚德丁杰心血管研究所收治的心肌梗死后左心室动脉瘤（LVA）患者。通过面积-长度法确定 LV 和 LVA 的超声心动图体积和表面积，并通过 Simpson 法确定 EF。. A-LVA 患者占 62.9%，D-LVA 患者占 37.1%。D-LVA 患者的收缩期动脉瘤体积（LVAVs）明显更高（94.07 ± 74.66 比 51.54 ± 53.09， = 0.009）、收缩期动脉瘤表面积（LVAAs）（23.22 ± 11.73 比 16.41 ± 8.58， = 0.018）和收缩末期左心室表面积（LVESA）（50.79 ± 13.33 比 42.76 ± 14.11， = 0.045）。与 A-LVA 患者相比，D-LVA 患者的 LVA 体积与 LV 体积之比更高（LVAVs/LVESV）。LV 的舒张末期容积（LVEDV）和 LV 的收缩末期容积（LVESV）在 D-LVA 和 A-LVA 之间没有显著差异。D-LVA 患者的 EF（21.25 ± 11.92 比 28.18 ± 11.91， = 0.044）明显较低。. 使用超声心动图区分 A-LVA 和 D-LVA 非常重要，因为 D-LVA 会导致 LV 功能更大的血流动力学紊乱，因此无论是否进行心肌血运重建手术，动脉瘤切除或 LV 重建都必须产生积极影响。
