Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study
<i>Background and Objectives</i>: Left ventricular aneurysm (LVA) causes geometric changes, including reduced systolic function and a more spherical shape, which is quantified by the sphericity index (SI), the ratio of the short to long axis in the apical four-chamber view. This study ai...
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2025-01-01
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| author | Slobodan Tomić Stefan Veljković Armin Šljivo Dragana Radoičić Goran Lončar Milovan Bojić |
| author_facet | Slobodan Tomić Stefan Veljković Armin Šljivo Dragana Radoičić Goran Lončar Milovan Bojić |
| author_sort | Slobodan Tomić |
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| description | <i>Background and Objectives</i>: Left ventricular aneurysm (LVA) causes geometric changes, including reduced systolic function and a more spherical shape, which is quantified by the sphericity index (SI), the ratio of the short to long axis in the apical four-chamber view. This study aimed to assess SI’s value in A-LVA and B-LVA, identify influencing factors, and evaluate its clinical relevance. <i>Materials and Methods</i>: This clinical study included 54 patients with post-infarction LVA and used echocardiography to determine LVA locations (A-LVA near the apex and B-LVA in the basal segments), with SI and other echocardiographic measures assessed in both systole and diastole for the entire cohort and stratified by A-LVA and B-LVA groups. <i>Results</i>: Among the 54 patients, 41 had A-LVA and 13 had B-LVA. The mean SI was 0.55 in diastole and 0.47 in systole for the cohort. Patients with A-LVA had a mean SI of 0.51 in diastole and 0.44 in systole, while B-LVA patients exhibited significantly higher SI values, with 0.65 in diastole and 0.57 in systole, due to lower long-axis (L) values in both phases. The mean left ventricular ejection fraction (EF) was 23.95% in A-LVA and 30.85% in B-LVA, with no significant difference. However, apical aneurysms were larger (greater LVAV and LVAA) and more significantly reduced functional myocardium. LVEDV, LVESV, LVEDA, and LVESA did not differ significantly between A-LVA and B-LVA. In cases of severe mitral regurgitation (MR), SI was notably higher (0.75 in diastole) due to a marked reduction in the L axis. <i>Conclusions</i>: SI is key in differentiating A-LVA and B-LVA on echocardiography. B-LVA has lower volume and area values, but similar aneurysm and left ventricular volumes and EF. Higher SI in B-LVA is due to a reduced L-axis, and is worsened by severe mitral regurgitation (MR). Surgical ventricular reconstruction (SVR) compensates for L-axis reduction, with preservation of the L axis critical for achieving a more physiological shape. SI thus serves as a marker for left ventricular geometry and surgical outcomes. |
| format | Article |
| id | doaj-art-c1d1ae6d948148ea8717694d67419912 |
| institution | Kabale University |
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| publishDate | 2025-01-01 |
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| spelling | doaj-art-c1d1ae6d948148ea8717694d674199122025-01-24T13:40:27ZengMDPI AGMedicina1010-660X1648-91442025-01-016116810.3390/medicina61010068Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical StudySlobodan Tomić0Stefan Veljković1Armin Šljivo2Dragana Radoičić3Goran Lončar4Milovan Bojić5Cardiovascular Institute ‘’Dedinje’’, 11040 Belgrade, SerbiaCardiovascular Institute ‘’Dedinje’’, 11040 Belgrade, SerbiaDepartment of Cardiosurgery, Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and HerzegovinaCardiovascular Institute ‘’Dedinje’’, 11040 Belgrade, SerbiaCardiovascular Institute ‘’Dedinje’’, 11040 Belgrade, SerbiaCardiovascular Institute ‘’Dedinje’’, 11040 Belgrade, Serbia<i>Background and Objectives</i>: Left ventricular aneurysm (LVA) causes geometric changes, including reduced systolic function and a more spherical shape, which is quantified by the sphericity index (SI), the ratio of the short to long axis in the apical four-chamber view. This study aimed to assess SI’s value in A-LVA and B-LVA, identify influencing factors, and evaluate its clinical relevance. <i>Materials and Methods</i>: This clinical study included 54 patients with post-infarction LVA and used echocardiography to determine LVA locations (A-LVA near the apex and B-LVA in the basal segments), with SI and other echocardiographic measures assessed in both systole and diastole for the entire cohort and stratified by A-LVA and B-LVA groups. <i>Results</i>: Among the 54 patients, 41 had A-LVA and 13 had B-LVA. The mean SI was 0.55 in diastole and 0.47 in systole for the cohort. Patients with A-LVA had a mean SI of 0.51 in diastole and 0.44 in systole, while B-LVA patients exhibited significantly higher SI values, with 0.65 in diastole and 0.57 in systole, due to lower long-axis (L) values in both phases. The mean left ventricular ejection fraction (EF) was 23.95% in A-LVA and 30.85% in B-LVA, with no significant difference. However, apical aneurysms were larger (greater LVAV and LVAA) and more significantly reduced functional myocardium. LVEDV, LVESV, LVEDA, and LVESA did not differ significantly between A-LVA and B-LVA. In cases of severe mitral regurgitation (MR), SI was notably higher (0.75 in diastole) due to a marked reduction in the L axis. <i>Conclusions</i>: SI is key in differentiating A-LVA and B-LVA on echocardiography. B-LVA has lower volume and area values, but similar aneurysm and left ventricular volumes and EF. Higher SI in B-LVA is due to a reduced L-axis, and is worsened by severe mitral regurgitation (MR). Surgical ventricular reconstruction (SVR) compensates for L-axis reduction, with preservation of the L axis critical for achieving a more physiological shape. SI thus serves as a marker for left ventricular geometry and surgical outcomes.https://www.mdpi.com/1648-9144/61/1/68left ventricular aneurysmsphericity indexechocardiographymitral regurgitationsurgical ventricular reconstruction |
| spellingShingle | Slobodan Tomić Stefan Veljković Armin Šljivo Dragana Radoičić Goran Lončar Milovan Bojić Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study Medicina left ventricular aneurysm sphericity index echocardiography mitral regurgitation surgical ventricular reconstruction |
| title | Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study |
| title_full | Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study |
| title_fullStr | Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study |
| title_full_unstemmed | Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study |
| title_short | Differentiating Apical and Basal Left Ventricular Aneurysms Using Sphericity Index: A Clinical Study |
| title_sort | differentiating apical and basal left ventricular aneurysms using sphericity index a clinical study |
| topic | left ventricular aneurysm sphericity index echocardiography mitral regurgitation surgical ventricular reconstruction |
| url | https://www.mdpi.com/1648-9144/61/1/68 |
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