Faxon D P, Ryan T J, Davis K B, McCabe C H, Myers W, Lesperance J, Shaw R, Tong T G
Am J Cardiol. 1982 Jul;50(1):157-64. doi: 10.1016/0002-9149(82)90023-6.
In order to evaluate the prognosis of medically treated patients with angiographically defined left ventricular aneurysm the data available from 1,136 patients with aneurysm (7.6 percent) from 15,019 patients with coronary artery disease in the Coronary Artery Surgery Study (CASS) registry were analyzed. Prior myocardial infarction, reduced ejection fraction, absence of angina and evidence of congestive heart failure were more commonly present in patients with aneurysm. The cumulative survival rates of medically treated patients at 1, 2, 3 and 4 years were 90, 84, 79 and 71 percent, respectively. The Cox analysis of survival indicated that the following variables predicted outcome: age, residual left ventricular function as assessed with angiography, left ventricular end-diastolic pressure, functional impairment due to congestive heart failure, number of vessels diseased, mitral regurgitation and S3 gallop. When survival was stratified for similar degrees of left ventricular dysfunction and functional impairment there was no difference between the survival of patients with aneurysm and that of registry patients without aneurysm. The data from this large population study indicate that the survival of patients with left ventricular aneurysm is better than previously recognized. The mortality in this group is primarily related to age, left ventricular function and clinical severity of heart failure. The presence of an aneurysm does not independently alter survival.
为了评估经药物治疗的血管造影确诊的左心室室壁瘤患者的预后，对冠状动脉外科研究（CASS）登记处15019例冠心病患者中1136例（7.6%）室壁瘤患者的现有数据进行了分析。室壁瘤患者更常出现既往心肌梗死、射血分数降低、无心绞痛以及充血性心力衰竭证据。药物治疗患者1年、2年、3年和4年的累积生存率分别为90%、84%、79%和71%。生存的Cox分析表明，以下变量可预测预后：年龄、血管造影评估的残余左心室功能、左心室舒张末期压力、充血性心力衰竭导致的功能损害、病变血管数量、二尖瓣反流和S3奔马律。当根据相似程度的左心室功能障碍和功能损害对生存进行分层时，室壁瘤患者与登记处无室壁瘤患者的生存率无差异。这项大型人群研究的数据表明，左心室室壁瘤患者的生存率比之前认为的要好。该组患者的死亡率主要与年龄、左心室功能和心力衰竭的临床严重程度有关。室壁瘤的存在并不会独立改变生存率。
