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  • Title: [Incidence of sudden cardiac death in relation to left ventricular anatomy and rhythm profile (author's transl)].
    Author: Lichtlen PR, Bethge KP, Platiel H.
    Journal: Z Kardiol; 1980 Sep; 69(9):639-48. PubMed ID: 6163258.
    Abstract:
    204 patients, undergoing coronary and left ventricular (LV) angiography as well as long-term ECG monitoring (20 and 24 hours, Meditape K, Siemens; Pathfinder, Reynolds), were followed for an average of 18.2 months (1-50 months); all showed obstructions of greater than or equal to 75% of one or several coronary branches (LAD, LCX, RCA); 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 sign. (p less than 0.025) correlation between PWM, esp. A and D and ventricular extrasystoles (VES) of Lown-Classes IV/V and N i.e. Lown-Classes 0-II, as well as the extent of the akinetic region. However, correlation between the extent of coronary disease (number of abnormal vessels) and VES was weak. -- 19 patients died suddenly i.e. within one hour (mortality 9.3%, i.e. 6.1% per year); 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 sign. (mortality for Lown-Classes 0-II = 5.4%, III = 7.9%, IV/V = 14.9%); however, mortality correlated sign. (p less than 0.025) with PWM (for D/A = 16.3%, H = 4.4%, N = 0%). The highest mortality (10/39 cases) of 25.6% i.e. 16.8% per year was found in patients with Lown-Classes IV/V and dys- or akinetic PWM. Thus, in patients with chronic CHD, severity of VES cannot be considered as an independent prognostic factor, but only in connection with the abnormal LV anatomy.
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