| Objective: this study was to investigate the clinical feathers and coronary artery character affecting acute aneurysm (AVA) formation and its heart performance during acute myocardial infarction (AMI) by coronary angiography (CAG) and left ventriculography (LVG).Material and methods: the present study was performed in 84 patients (67 men, 13 women, 59+11.63y) who suffered from primary acute myocardial infarction. Exclusions to the study were the history of obsolete myocardial infarction, severe valvular heart disease, dilated and hypertrophic cardiomyopathy, heart function Killip IV and cardiogenic shock. All patients were submitted to coronary angiography (CAG), percutaneous coronary intervention (PCI) and left ventriculography (LVG) between 2 and 72 hours as soon as possible and divided into two groups according to the AVA formation seen in LVG. LVA was confirmed according to the criterion of The Coronary Artery Surgery Study (CASS) and Meizlish JL and left ventricular end diastolic pressure (LVEDP) was recorded before and after LVG.A11 patients underwent equilibrium radionuclide angiography (ERNA)between 2 and 7 days after the onset of AMI to evaluate the heart function and ventricular systolic synchrony (VSS).Result: there is no significant difference between the two groups about the age, sex, addiction for smoking and drinking and levels of CK and CKMB. The incidence of AVA is higher of the patients with hypertension than that of patients without hypertension(65.0% vs 30.1%, p<0.05). On contrast, patients with diabetes and angina pectoris before AMI have lower incidence of AVA compared with those without diabetes and angina pectoris (9.38% vs 30.4%, 37.5% vs 57.6%, 28.2% vs 52.9% respectively, p<0.05). AVA formation has a noted relation to the time of infarct related artery (IRA) occlusion after AMI onset. The time of IRA occlusion of patients with AVA is noted prolonged compared with that of patients without AVA (19.78+5.65h vs 11.21+4.55h, p<0.05) . Furthermore, the incidence of AVA is increased with the time of IRA occlusion. The incidence of AVA have noted positive relation to the time of IRA occlusion by correlation analysis. The coronary stenosis of the patients with AVA is mainly lying in left anterior descending artery (LAD) (75%), occluded or suboccluded single coronary artery without an adequate collateral blood supply. The mortality during hospitalization of AVA patients is higher than that of non-AVA patients (18.75% vs 3.85%, p<0.05). Time of IRA occlusion, occluded or suboccluded LAD without efficient collate artery (OR: 8.2, 95%CI: 4.6-11.8) and hypertension (OR:4.6, 95% CI: 2.4-6.8) are independent crisis factors of AVA, and diabetes (OR: 0.157, 95%CI: 0.129-0.185) and muti-branch lesion (OR: 0.178, 95%CI: 0.148-0.208) release AVA formation by using Logistic muti-variable regression analysis. The heart function especially the systolic function of patients with AVA is noted injured compared with that of patients without AVA (LVEF 48.62+16.86% vs 63.08 + 11.23%, PER2.71+0.91 EDV/s vs 3.53+0.73EDV/S , p<0.05) . LVEDP of patients with AVA is higher than that of patients without AVA (20.83?.85mmHg vs 16.59+ 6.18mmHg, p<0.05). LVEDP after LVG is higher than that before LVG in patients with AVA (26.67+9.51mmHg vs 20.83+8.85mmHg, p<0.05). The difference between LVEDP after and before LVG is no significance in patients without AVA. The difference of the increased degree of the two groups is significant. (5.83+2.66mmHg vs 2.71+1.70mmHg, p<0.05). The patients with AVA have worse VSS compared with patients without AVA and PSD, PS and FWHM of AVA patients were increased 48.3%, 58.7% 27.0% compared with non-AVA patients (p<0.05) .Conclusion: the diagnosis of AVA by performing LVG after direct or rescue PCI during AMI was a rather efficient and safe method. AVA formation was affected by many factors associated with the heart function injured and with poor prognosis and higher mortality during hospitalization.
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