HEMODYNAMIC ASSESSMENT DURING EXERCISE AFTER LEFT-VENTRICULAR ANEURYSMECTOMY

The exercise hemodynamics of eight patients who underwent cardiac cath eterization were assessed at rest and during exercise, before and afte r left ventricular aneurysmectomy by the classical technique. Left ven tricular end-diastolic volume increased before operation and then sign ificantly decreased after the operation (p < 0.05). The ejection fract ion increased from 0.27 before the operation to 0.46 after the operati on (p < 0.01). The cardiac index, which was low before operation, incr eased within the normal range after operation. Mean systolic circumfer ential tension also decreased significantly (p < 0.01) after the opera tion. Thus, the indexes at rest showed improvement. Left ventricular e nd-diastolic pressure showed a decreasing tendency after the operation both at rest and during exercise in comparison with that before the o peration. However, the difference was not significant. The stroke work index increased significantly during exercise after the operation (p < 0.05). Before the operation, the stroke work index did not increase despite the elevation of left ventricular end-diastolic pressure; howe ver, after the operation, the stroke work index increased during exerc ise without much increase of left ventricular end-diastolic pressure. This indicated improvement in the Frank-Starling curve and recovery of preload reserve by the resection of the left ventricular aneurysm. Th us, an important factor for demonstrating improvement in postoperative cardiac function was clarified through its relation to exercise load.