Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1984 Jun;51(6):631–636. doi: 10.1136/hrt.51.6.631

Measurement of left ventricular ejection fraction after acute myocardial infarction. A serial cross sectional echocardiographic study.

G Kan, C A Visser, K I Lie, D Durrer
PMCID: PMC481564  PMID: 6732993

Abstract

Left ventricular ejection fraction was assessed by biplane cross sectional echocardiography in 65 patients with a first acute myocardial infarction on the first day. In 30 patients (group 1) measurements were repeated on the third day and in another 35 patients (group 2) at three months. Changes in ejection fraction of 0.05 or less were arbitrarily called insignificant. In group 1 only two patients showed a decrease of more than 0.1 between days 1 and 3, and both had an enzymatically confirmed infarct extension. The remaining patients had no complications. In group two 11 patients had decreases of more than 0.1 between day 1 and three months: three of them had an enzymatically confirmed reinfarction (perioperative in one) and four a possible reinfarction, and in two an angiographically confirmed left ventricular aneurysm developed. In two no complications occurred. The other complications that occurred were an enzymatically confirmed but small reinfarction, an angiographically confirmed but circumscript aneurysm, and an uncomplicated bypass operation in one patient each. These three patients had a small increase (between 0.05 and 0.1) in ejection fraction. Reproducibility of the method of measuring the ejection fraction was assessed concurrently in 20 outpatients with a previous myocardial infarction who were studied twice on the same day (with a 30 minute interval) by two different observers. The mean absolute difference in ejection fraction between the paired observations was 0.036 +/- 0.023 with a range of 0 to 0.07. Thus only changes in ejection fraction of more than 0.1 correlate with clinically recognised complications. Changes between 0.05 and 0.1 may be due to spontaneous variability or to the limited reproducibility of the method.

Full text

PDF
631

Images in this article

632Image
on p.632

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Azancot I., Beaufils P., Masquet C., Georgiopoulos G., Babalis D., Lorente P., Baudouy Y., Slama R., Bouvrain Y. Detection of residual myocardial function in acute transmural infarction using postextrasystolic potentiation. A computerized angiographic study. Circulation. 1981 Jul;64(1):46–53. doi: 10.1161/01.cir.64.1.46. [DOI] [PubMed] [Google Scholar]
  2. Carr K. W., Engler R. L., Forsythe J. R., Johnson A. D., Gosink B. Measurement of left ventricular ejection fraction by mechanical cross-sectional echocardiography. Circulation. 1979 Jun;59(6):1196–1206. doi: 10.1161/01.cir.59.6.1196. [DOI] [PubMed] [Google Scholar]
  3. Edelman Sidney K., Rowe Dennis W., Pechacek Leonard W., Garcia Efrain. Left ventricular volumes and ejection fraction derived from apical two-dimensional echocardiography. Cardiovasc Dis. 1981 Sep;8(3):344–354. [PMC free article] [PubMed] [Google Scholar]
  4. Fiolet J. W., Willebrands A. F., Lie K. I., ter Welle H. F. Determination of creatine kinase isoenzyme MB (CK-MB): comparison of methods and clinical evaluation. Clin Chim Acta. 1977 Oct 1;80(1):23–35. doi: 10.1016/0009-8981(77)90260-1. [DOI] [PubMed] [Google Scholar]
  5. Folland E. D., Parisi A. F., Moynihan P. F., Jones D. R., Feldman C. L., Tow D. E. Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography. A comparison of cineangiographic and radionuclide techniques. Circulation. 1979 Oct;60(4):760–766. doi: 10.1161/01.cir.60.4.760. [DOI] [PubMed] [Google Scholar]
  6. Gorlin R., Klein M. D., Sullivan J. M. Prospective correlative study of ventricular aneurysm. Mechanistic concept and clinical recognition. Am J Med. 1967 Apr;42(4):512–531. doi: 10.1016/0002-9343(67)90051-4. [DOI] [PubMed] [Google Scholar]
  7. Henry W. L., DeMaria A., Gramiak R., King D. L., Kisslo J. A., Popp R. L., Sahn D. J., Schiller N. B., Tajik A., Teichholz L. E. Report of the American Society of Echocardiography Committee on Nomenclature and Standards in Two-dimensional Echocardiography. Circulation. 1980 Aug;62(2):212–217. doi: 10.1161/01.cir.62.2.212. [DOI] [PubMed] [Google Scholar]
  8. Jenni R., Vieli A., Hess O., Anliker M., Krayenbuehl H. P. Estimation of left ventricular volume from apical orthogonal 2-D echocardiograms. Eur Heart J. 1981 Jun;2(3):217–225. doi: 10.1093/oxfordjournals.eurheartj.a061197. [DOI] [PubMed] [Google Scholar]
  9. Kan G., Visser C. A., Lie K. I., Durrer D. Left ventricular volumes and ejection fraction by single plane two-dimensional apex echocardiography. Eur Heart J. 1981 Aug;2(4):339–343. doi: 10.1093/oxfordjournals.eurheartj.a061214. [DOI] [PubMed] [Google Scholar]
  10. Nemerovski M., Shah P. K., Pichler M., Berman D. S., Shellock F., Swan H. J. Radionuclide assessment of sequential changes in left and right ventricular function following first acute transmural myocardial infarction. Am Heart J. 1982 Oct;104(4 Pt 1):709–717. doi: 10.1016/0002-8703(82)90001-1. [DOI] [PubMed] [Google Scholar]
  11. Parisi A. F., Moynihan P. F., Feldman C. L., Folland E. D. Approaches to determination of left ventricular volume and ejection fraction by real-time two-dimensional echocardiography. Clin Cardiol. 1979 Aug;2(4):257–263. doi: 10.1002/clc.4960020404. [DOI] [PubMed] [Google Scholar]
  12. Reduto L. A., Berger H. J., Cohen L. S., Gottschalk A., Zaret B. L. Sequential radionuclide assessment of left and right ventricular performance after acute transmural myocardial infarction. Ann Intern Med. 1978 Oct;89(4):441–447. doi: 10.7326/0003-4819-89-4-441. [DOI] [PubMed] [Google Scholar]
  13. Rigo P., Murray M., Strauss H. W., Taylor D., Kelly D., Weisfeldt M., Pitt B. Left ventricular function in acute myocardial infarction evaluation by gated scintiphotography. Circulation. 1974 Oct;50(4):678–684. doi: 10.1161/01.cir.50.4.678. [DOI] [PubMed] [Google Scholar]
  14. Sandler H., Dodge H. T. The use of single plane angiocardiograms for the calculation of left ventricular volume in man. Am Heart J. 1968 Mar;75(3):325–334. doi: 10.1016/0002-8703(68)90089-6. [DOI] [PubMed] [Google Scholar]
  15. Sanford C. F., Corbett J., Nicod P., Curry G. L., Lewis S. E., Dehmer G. J., Anderson A., Moses B., Willerson J. T. Value of radionuclide ventriculography in the immediate characterization of patients with acute myocardial infarction. Am J Cardiol. 1982 Mar;49(4):637–644. doi: 10.1016/0002-9149(82)91940-3. [DOI] [PubMed] [Google Scholar]
  16. Schelbert H. R., Henning H., Ashburn W. L., Verba J. W., Karliner J. S., O'Rourke R. A. Serial measurements of left ventricular ejection fraction by radionuclide angiography early and late after myocardial infarction. Am J Cardiol. 1976 Oct;38(4):407–415. doi: 10.1016/0002-9149(76)90455-0. [DOI] [PubMed] [Google Scholar]
  17. Schiller N. B., Acquatella H., Ports T. A., Drew D., Goerke J., Ringertz H., Silverman N. H., Brundage B., Botvinick E. H., Boswell R. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation. 1979 Sep;60(3):547–555. doi: 10.1161/01.cir.60.3.547. [DOI] [PubMed] [Google Scholar]
  18. Schnittger I., Fitzgerald P. J., Daughters G. T., Ingels N. B., Kantrowitz N. E., Schwarzkopf A., Mead C. W., Popp R. L. Limitations of comparing left ventricular volumes by two dimensional echocardiography, myocardial markers and cineangiography. Am J Cardiol. 1982 Sep;50(3):512–519. doi: 10.1016/0002-9149(82)90317-4. [DOI] [PubMed] [Google Scholar]
  19. Shah P. K., Pichler M., Berman D. S., Singh B. N., Swan H. J. Left ventricular ejection fraction determined by radionuclide ventriculography in early stages of first transmural myocardial infarction. Relation to short-term prognosis. Am J Cardiol. 1980 Mar;45(3):542–546. doi: 10.1016/s0002-9149(80)80002-6. [DOI] [PubMed] [Google Scholar]
  20. Silverman N. H., Ports T. A., Snider A. R., Schiller N. B., Carlsson E., Heilbron D. C. Determination of left ventricular volume in children: echocardiographic and angiographic comparisons. Circulation. 1980 Sep;62(3):548–557. doi: 10.1161/01.cir.62.3.548. [DOI] [PubMed] [Google Scholar]
  21. Starling M. R., Crawford M. H., Sorensen S. G., Levi B., Richards K. L., O'Rourke R. A. Comparative accuracy of apical biplane cross-sectional echocardiography and gated equilibrium radionuclide angiography for estimating left ventricular size and performance. Circulation. 1981 May;63(5):1075–1084. doi: 10.1161/01.cir.63.5.1075. [DOI] [PubMed] [Google Scholar]
  22. Visser C. A., Lie K. I., Kan G., Meltzer R., Durrer D. Detection and quantification of acute, isolated myocardial infarction by two dimensional echocardiography. Am J Cardiol. 1981 May;47(5):1020–1025. doi: 10.1016/0002-9149(81)90207-1. [DOI] [PubMed] [Google Scholar]
  23. Wackers F. J., Berger H. J., Johnstone D. E., Goldman L., Reduto L. A., Langou R. A., Gottschalk A., Zaret B. L. Multiple gated cardiac blood pool imaging for left ventricular ejection fraction: validation of the technique and assessment of variability. Am J Cardiol. 1979 Jun;43(6):1159–1166. doi: 10.1016/0002-9149(79)90148-6. [DOI] [PubMed] [Google Scholar]
  24. Wackers F. J., Berger H. J., Weinberg M. A., Zaret B. L. Spontaneous changes in left ventricular function over the first 24 hours of acute myocardial infarction: implications for evaluating early therapeutic interventions. Circulation. 1982 Oct;66(4):748–754. doi: 10.1161/01.cir.66.4.748. [DOI] [PubMed] [Google Scholar]
  25. Wynne J., Sayres M., Maddox D. E., Idoine J., Alpert J. S., Neill J., Holman B. L. Regional left ventricular function in acute myocardial infarction: evaluation with quantitative radionuclide ventriculography. Am J Cardiol. 1980 Feb;45(2):203–209. doi: 10.1016/0002-9149(80)90636-0. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES