M-mode and two-dimensional echocardiograms were performed using an Apogee CX-200 equipment (ATL, Bothell, Washington, USA) with a 4-megahertz broadband transducer. The echocardiograms were analyzed by a trained observer blinded to the study protocol Echocardiographic parameters were assessed according to standard procedures of the Section of Echocardiography of the Department of Cardiology, with special care taken to detect left ventricular apical aneurysms. The echocardiographic parameters assessed were left ventricular ejection fraction (LVEF) calculated by the teichholz method, left atrial diameter (LAD), presence of pulmonary arterial hypertension (defined as maximal pulmonary arterial pressure > 30 mmHg, diastolic dysfunction, and the presence of an apical aneurysm. Normal cut-off value for LVEF was defined as >50%. Routine echocardiograms were performed in order to track changes in LVEF during follow-up.