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Thorac Cardiovasc Surg 2004; 52(5): 274-279
DOI: 10.1055/s-2004-821077
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Pre- and Postoperative Assessment of Left Ventricular Function by Magnetic Resonance Imaging and 2-D-Echocardiography in Patients Undergoing Left Ventricular Aneurysmectomy

T. Dill1 , C. Breidenbach1 , A. John1 , R. R. Brandt1 , O. Ekinci1 , Z. Szalay3 , E. P. Bauer3 , W. Ricken1 , G. Bachmann2 , C. W. Hamm1
  • 1Department of Cardiology, Kerckhoff-Heart Center, Bad Nauheim, Germany
  • 2Department of Radiology, Kerckhoff-Heart Center, Bad Nauheim, Germany
  • 3Department of Cardiovascular Surgery, Kerckhoff-Heart Center, Bad Nauheim, Germany
Further Information

Publication History

Received January 19, 2003

Publication Date:
06 October 2004 (online)

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Abstract

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.

Key words

Magnetic resonance imaging - echocardiography - LV function - LV aneurysm

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Dr. Thorsten Dill

Department of Cardiology/Cardiovascular Magnetic Resonance, Kerckhoff Heart Center

Benekestraße 2 - 8

61231 Bad Nauheim

Germany

Phone: + 4960329960

Fax: + 49 6 03 29 96 22 98

Email: t.dill@kerckhoff-klinik.de