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Determinants of ventricular tachycardia in patients with coronary artery disease and ventricular aneurysm: Clinical, hemodynamic and angiographic factors

Many patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patien... Full description

Journal Title: The American journal of cardiology 1983-01-01, Vol.51 (1), p.61-64
Main Author: Cohen, M
Other Authors: Wiener, I , Pichard, A , Holt, J , Smith, Jr, H , Gorlin, R
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/6849268
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recordid: cdi_proquest_miscellaneous_80349771
title: Determinants of ventricular tachycardia in patients with coronary artery disease and ventricular aneurysm: Clinical, hemodynamic and angiographic factors
format: Article
creator:
  • Cohen, M
  • Wiener, I
  • Pichard, A
  • Holt, J
  • Smith, Jr, H
  • Gorlin, R
subjects:
  • Abridged Index Medicus
  • Adult
  • Aged
  • Coronary Disease - complications
  • Coronary Disease - diagnostic imaging
  • Coronary Disease - physiopathology
  • Female
  • Heart Aneurysm - complications
  • Heart Aneurysm - diagnostic imaging
  • Heart Aneurysm - physiopathology
  • Heart Ventricles - diagnostic imaging
  • Heart Ventricles - physiopathology
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction - etiology
  • Radiography
  • Tachycardia - complications
  • Tachycardia - diagnostic imaging
  • Tachycardia - physiopathology
ispartof: The American journal of cardiology, 1983-01-01, Vol.51 (1), p.61-64
description: Many patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patients with aneurysms, we retrospectively reviewed the records of 154 patients with CAD and segments of akinesia or dyskinesia, or both, on left ventriculography. Of the 154 patients, 85 had 24-hour Holter monitoring or 48 consecutive hours of continuous electrocardiographic monitoring in an intensive care unit within 6 months of catheterization. VT occurring at least 10 days after myocardial infarction (MI) or in the chronic phase was recorded in 19 patients (Group I); the remaining 66 patients did not have VT (Group II). The clinical, hemodynamic, and angiographic characteristics of these 2 groups showed no significant difference with respect to age, time from first transmural MI to catheterization, congestive heart failure (CHF), ejection fraction, or presence of dyskinesia. Patients with VT had significantly larger aneurysms and a higher prevalence of septal akinesia or dyskinesia. However, stepwise discriminant analysis revealed septal akinesia or dyskinesia to be the only independently significant variable distinguishing the 2 groups. Thus, septal involvement appears to be a major determinant of VT in patients with CAD and ventricular aneurysm.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0002-9149
fulltext: fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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descriptionMany patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patients with aneurysms, we retrospectively reviewed the records of 154 patients with CAD and segments of akinesia or dyskinesia, or both, on left ventriculography. Of the 154 patients, 85 had 24-hour Holter monitoring or 48 consecutive hours of continuous electrocardiographic monitoring in an intensive care unit within 6 months of catheterization. VT occurring at least 10 days after myocardial infarction (MI) or in the chronic phase was recorded in 19 patients (Group I); the remaining 66 patients did not have VT (Group II). The clinical, hemodynamic, and angiographic characteristics of these 2 groups showed no significant difference with respect to age, time from first transmural MI to catheterization, congestive heart failure (CHF), ejection fraction, or presence of dyskinesia. Patients with VT had significantly larger aneurysms and a higher prevalence of septal akinesia or dyskinesia. However, stepwise discriminant analysis revealed septal akinesia or dyskinesia to be the only independently significant variable distinguishing the 2 groups. Thus, septal involvement appears to be a major determinant of VT in patients with CAD and ventricular aneurysm.
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subjectAbridged Index Medicus ; Adult ; Aged ; Coronary Disease - complications ; Coronary Disease - diagnostic imaging ; Coronary Disease - physiopathology ; Female ; Heart Aneurysm - complications ; Heart Aneurysm - diagnostic imaging ; Heart Aneurysm - physiopathology ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Hemodynamics ; Humans ; Male ; Middle Aged ; Myocardial Infarction - etiology ; Radiography ; Tachycardia - complications ; Tachycardia - diagnostic imaging ; Tachycardia - physiopathology
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descriptionMany patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patients with aneurysms, we retrospectively reviewed the records of 154 patients with CAD and segments of akinesia or dyskinesia, or both, on left ventriculography. Of the 154 patients, 85 had 24-hour Holter monitoring or 48 consecutive hours of continuous electrocardiographic monitoring in an intensive care unit within 6 months of catheterization. VT occurring at least 10 days after myocardial infarction (MI) or in the chronic phase was recorded in 19 patients (Group I); the remaining 66 patients did not have VT (Group II). The clinical, hemodynamic, and angiographic characteristics of these 2 groups showed no significant difference with respect to age, time from first transmural MI to catheterization, congestive heart failure (CHF), ejection fraction, or presence of dyskinesia. Patients with VT had significantly larger aneurysms and a higher prevalence of septal akinesia or dyskinesia. However, stepwise discriminant analysis revealed septal akinesia or dyskinesia to be the only independently significant variable distinguishing the 2 groups. Thus, septal involvement appears to be a major determinant of VT in patients with CAD and ventricular aneurysm.
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abstractMany patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patients with aneurysms, we retrospectively reviewed the records of 154 patients with CAD and segments of akinesia or dyskinesia, or both, on left ventriculography. Of the 154 patients, 85 had 24-hour Holter monitoring or 48 consecutive hours of continuous electrocardiographic monitoring in an intensive care unit within 6 months of catheterization. VT occurring at least 10 days after myocardial infarction (MI) or in the chronic phase was recorded in 19 patients (Group I); the remaining 66 patients did not have VT (Group II). The clinical, hemodynamic, and angiographic characteristics of these 2 groups showed no significant difference with respect to age, time from first transmural MI to catheterization, congestive heart failure (CHF), ejection fraction, or presence of dyskinesia. Patients with VT had significantly larger aneurysms and a higher prevalence of septal akinesia or dyskinesia. However, stepwise discriminant analysis revealed septal akinesia or dyskinesia to be the only independently significant variable distinguishing the 2 groups. Thus, septal involvement appears to be a major determinant of VT in patients with CAD and ventricular aneurysm.
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pmid6849268
doi10.1016/S0002-9149(83)80011-3