INCIDENCE OF SUDDEN CARDIAC DEATH IN RELATION TO LEFT-VENTRICULAR ANATOMY AND RHYTHM PROFILE

  • 1 January 1980
    • journal article
    • research article
    • Vol. 69  (9) , 639-648
Abstract
Patients (204) undergoing coronary and left ventricular (LV) angiography and long-term ECG monitoring (20 and 24 h) were followed for an average 18.2 mo.; all showed obstructions of .gtoreq. 75% of 1 or several coronary branches; qualitative and quantitative assessment of poststenotic LV wall motion (PWM) (percent shortening of 18 halfaxes) revealed akinesis or dyskinesis (A/D) in 55%, hypokinesis in 29% and normokinesis in 16% of the cases. Long-term ECG-monitoring showed a significant (P < 0.025) correlation between PWM (A and D) and ventricular extrasystoles (VES) of Lown-Classes IV/V and N, i.e., Lown-Classes 0-II and the extent of the akinetic region. Correlation between the extent of coronary disease (number of abnormal vessels) and VES was weak. Patients (19) died suddenly, within 1 h; 10 patients were in Lown-Class IV/V (53%), 15 (79%) showed A or D, 4 (21%) H in the LV angiogram; in no case was PWM normal. Correlation between degree of VES (Lown-Classes) and mortality was not significant; mortality correlated importantly (P < 0.025) with PWM. The highest mortality of 25.6% (16.8%/yr) was found in patients with Lown-Classes IV/V and dys- or akinetic PWM. In patients with chronic CHD, severity of VES cannot be considered an independent prognostic factor, but in connection with the abnormal LV anatomy.

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