Document Detail

Wall motion abnormalities and late ventricular arrhythmia during the predischarge phase of acute myocardial infarction.
MedLine Citation:
PMID:  7654399     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular wall aneurysm is a complication of acute myocardial infarction which has been considered a precipitating factor of cardiac failure and ventricular arrhythmia. We have evaluated the relation between severe left ventricular wall motion abnormalities and ventricular arrhythmia. METHODS: During a two-year period 146 patients admitted to a coronary care unit with acute myocardial infarction were studied. Radionuclide angiography performed within the second and the fourth weeks was used to analyse phase and wall motility changes, and patients were divided into three groups: 1) Hypokinesia and/or akinesia localized to one segment: with no or slight changes in phase image--102 patients; 2) Aneurysm: left ventricular deformity with well-defined chromatic changes in phase image--19 patients; and 3) Dyskinesia and/or extensive akinesia of two or more segments: phase image with diffuse heterogeneous changes--25 patients. Ventricular arrhythmia was studied using Holter electrocardiography taken during the second week of acute myocardial infarction. Three rhythmic profiles were considered: no premature ventricular contractions--41 patients; with three or more than three premature ventricular contractions per hour--38 patients; repetitive premature ventricular contractions--20 patients. RESULTS: Premature ventricular contractions were absent in 31 (30%) of the patients with hypokinesia/localized akinesia vs 8 (42%) of the patients with aneurysm, and vs 2 (8%) of the patients with dyskinesia/extensive akinesia. Premature ventricular contractions were frequent (> or = 3/h) in 22 (22%) of the patients with hypokinesia/localized akinesia vs 4 (21%) of the patients with aneurysm (p = 0.35; NS), and vs 12 (48%) of the patients with dyskinesia/extensive akinesia (p=0.003). Repetitive premature ventricular contractions were present in 10 (10%) of the patients with hypokinesia/localized akinesia vs 2 (11%) of the patients with aneurysm, and vs 8 (32%) of the patients with dyskinesia/extensive akinesia (p=0.008). CONCLUSIONS: We conclude that the presence of aneurysm was not associated with a higher occurrence of ventricular arrhythmia, but patients with dyskinesia/extensive akinesia had a higher occurrence of ventricular arrhythmia, > or = 3 premature ventricular contractions per hour and repetitive premature ventricular contractions. Our results suggest that ventricular arrhythmia is related to functionally severe wall motion abnormalities, and not to anatomical discriminants. This finding leads us to suggest different electrophysiological mechanisms behind these two entities.
A L Bordalo-Sá; M E Sá; M J Correia; G Cantinho; A Longo; L Neves; R Ferreira; J L Tuna; C Ribeiro
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology     Volume:  14     ISSN:  0870-2551     ISO Abbreviation:  Rev Port Cardiol     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-09-29     Completed Date:  1995-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8710716     Medline TA:  Rev Port Cardiol     Country:  PORTUGAL    
Other Details:
Languages:  eng     Pagination:  383-93, 360     Citation Subset:  IM    
UTIC-Arsénio Cordeiro (CCU), Hospital Santa Maria, Faculdade de Medicina de Lisboa, Portugal.
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MeSH Terms
Aged, 80 and over
Arrhythmias, Cardiac / etiology
Electrocardiography, Ambulatory
Gated Blood-Pool Imaging
Middle Aged
Myocardial Infarction / complications,  physiopathology*,  radionuclide imaging
Time Factors

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