[Left ventricular dilatation after myocardial infarct].

The aim of this prospective study was to investigate if left ventricular dilatation is confined to the early months following myocardial infarction, or if it is a progressive process over several years. One hundred patients (pts) who suffered from stable angina or had undergone myocardial infarction, could be examined twice by coronary arteriography including ventriculography in an interval of 52 +/- 14 months. The patients were retrospectively divided into three groups: 41 pts (group A) had coronary heart disease without prior myocardial infarction, in 29 pts (group B) the first examination was performed within (mean 2 +/- 1 mo.) and in 30 pts (group C) beyond 6 months after myocardial infarction (mean 32 +/- 24 mo). The three groups were comparable concerning clinical data, but more pts with former myocardial infarction had multi-vessel disease (34 of 59 vs 16 of 41 pts) and depressed left ventricular function. Left ventricular angiography was performed in RAO view 30 degrees after enddiastolic pressure (LVEDP) was registered. Left ventricular enddiastolic and endsystolic volumes (EDVI and ESVI) were calculated by use of a modified Simpson's rule equation. In group A, EDVI and LVEDP remained constant, whereas ESVI increased slightly but significantly. Pts of group B and C had significantly higher volumes, which increased significantly in both groups over a mean of 52 months. About half the pts suffered from ventricular dilatation independent of progression of underlying coronary sclerosis. Consecutively, left ventricular ejection fraction decreased and LVEDP rose significantly in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)