XXXX . Hemodynamic and prognostic implications.

@entity1 @entity340 @entity583 @entity5988 @entity6 @entity101 @entity453 @entity67 @entity204
To assess the prevalence and significance of @entity5988 in @entity1 with severe left @entity67 secondary to @entity453 (or @entity453 ), we studied 70 @entity1 with an ejection fraction of 35 percent or @entity453 (n = 14) or with multivessel @entity453 (n = 56). None had had a recent @entity583 or @entity340 . @entity1 who underwent myocardial revascularization during follow-up were excluded. The left ventricular end-diastolic volume (measured by contrast ventriculography) was less than 110 ml/sq m in 14 @entity1 (20 percent) (group 1), and was 110 ml/sq m or more in 56 @entity1 (80 percent) (group 2). There were no differences between the two groups in age, sex, @entity6 , @entity101 , extent of @entity453 , or left @entity67 . @entity1 in group 1 had lower pulmonary arterial wedge pressure (13 +/- 6 vs 22 +/- 10 mm Hg; p = 0.0008), lower left ventricular end-diastolic pressure (21 +/- 6 vs 27 +/- 9 mm Hg; p = 0.007), and higher left ventricular ejection fraction (31 +/- 2 vs 25 +/- 7 percent; p = 0.001) than @entity1 in group 2. At a mean follow-up of 27 months, 24 @entity1 had died of cardiac causes, all of whom were in group 2. Survival was significantly better in group 1 than in group 2 (Mantel-Cox, p = 0.009). Survival analysis (Cox models) of 20 clinical, hemodynamic, and angiographic variables showed that ejection fraction (chi2 = 13.6; p less than 0.001) and end-diastolic volume chi2 = 4.7; p = 0.03) were the most significant predictors of @entity204 . Thus, minimally dilated @entity453 is a distinct entity with favorable hemodynamics. Prognostically, the end-diastolic volume adds significant predictive information to the ejection fraction among conservatively treated @entity1 .
