TY - JOUR
T1 - Left ventricular ejection fraction and first third ejection fraction early after acute myocardial infarction
T2 - Value for predicting mortality and morbidity
AU - Battler, Alexander
AU - Slutsky, Robert
AU - Karliner, Joel
AU - Froelicher, Victor
AU - Ashburn, William
AU - Ross, John
N1 - Funding Information:
From the Division of Cardiology, Department of Medicine and the Division of Nuclear Medicine, Department of Radiology, University of California, San Diego, California. This work was supported by Specialized Center of Research on lschemic Heart Disease NIH Research Grant HL 17682 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. Manuscript received May 3, 1979; revised manuscript received August 6, 1979, accepted September 12, 1979. + Present address: Alexander Battler, MD, Heart Insitute. the Chaim Sheba Medical Center, Tel Hashomer, Israel. Address for reprints: John Ross, Jr., MD, Division of Cardiology, Department of Medicine, M-013. University of California, San Diego, La Jolla, California 92093.
PY - 1980/2
Y1 - 1980/2
N2 - In 102 patients with acute myocardial infarction total ejection fraction was measured 1 to 4 days after hospital admission with simultaneous measurement of first third ejection fraction, using first pass radionuclide angiography, in 44. Ejection fraction was reduced (< 0.52) in 71 patients (70 percent) and first third ejection fraction was depressed (< 0.25) in all 44 patients with this measurement. Among 98 patients followed up for 30 days, the admission ejection fraction was normal in 30 (31 percent, group A) and reduced in 68 (69 percent, group B). Mortality was similar in groups A and B (10 versus 9 percent) at 30 days but at 1 year was greater in group B (24 versus 10 percent); between 1 month and 1 year there were no further deaths in group A. First third ejection fraction was < 0.17 in all 9 of the 44 patients with this determination who died within the 1st year; in 2 of the 9 total ejection fraction was > 0.52. Nine of 21 patients (43 percent) with a first third ejection fraction value of < 0.17 and 0 of 23 with a value of ≥ 0.17 died within the 1st year (p < 0.005). Eighty-seven patients were followed up for 2 to 18 months (mean 11). The incidence of angina pectoris was similar in groups A (13 of 27, 48 percent) and B (27 of 60, 45 percent). Congestive heart failure occurred in 30 patients (50 percent) in group B and in only 4 (15 percent) in group A. At the end of the follow-up period, 46 of 66 patients (70 percent) in group B and 7 of 30 (23 percent) in group A had died or had congestive heart failure (p < 0.05). Thus, relatively early after admission for acute myocardial infarction total ejection fraction can fail to show left ventricular dysfunction in one third of patients, whereas the first third ejection fraction appears to be highly sensitive for detecting depressed left ventricular function. A total ejection fraction of < 0.52 predicted a significantly increased combined morbidity from congestive heart failure and mortality during the 1st year after infarction, and a first third ejection fraction of < 0.17 also predicted increased mortality during that period.
AB - In 102 patients with acute myocardial infarction total ejection fraction was measured 1 to 4 days after hospital admission with simultaneous measurement of first third ejection fraction, using first pass radionuclide angiography, in 44. Ejection fraction was reduced (< 0.52) in 71 patients (70 percent) and first third ejection fraction was depressed (< 0.25) in all 44 patients with this measurement. Among 98 patients followed up for 30 days, the admission ejection fraction was normal in 30 (31 percent, group A) and reduced in 68 (69 percent, group B). Mortality was similar in groups A and B (10 versus 9 percent) at 30 days but at 1 year was greater in group B (24 versus 10 percent); between 1 month and 1 year there were no further deaths in group A. First third ejection fraction was < 0.17 in all 9 of the 44 patients with this determination who died within the 1st year; in 2 of the 9 total ejection fraction was > 0.52. Nine of 21 patients (43 percent) with a first third ejection fraction value of < 0.17 and 0 of 23 with a value of ≥ 0.17 died within the 1st year (p < 0.005). Eighty-seven patients were followed up for 2 to 18 months (mean 11). The incidence of angina pectoris was similar in groups A (13 of 27, 48 percent) and B (27 of 60, 45 percent). Congestive heart failure occurred in 30 patients (50 percent) in group B and in only 4 (15 percent) in group A. At the end of the follow-up period, 46 of 66 patients (70 percent) in group B and 7 of 30 (23 percent) in group A had died or had congestive heart failure (p < 0.05). Thus, relatively early after admission for acute myocardial infarction total ejection fraction can fail to show left ventricular dysfunction in one third of patients, whereas the first third ejection fraction appears to be highly sensitive for detecting depressed left ventricular function. A total ejection fraction of < 0.52 predicted a significantly increased combined morbidity from congestive heart failure and mortality during the 1st year after infarction, and a first third ejection fraction of < 0.17 also predicted increased mortality during that period.
UR - http://www.scopus.com/inward/record.url?scp=0018900849&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(80)90635-9
DO - 10.1016/0002-9149(80)90635-9
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AN - SCOPUS:0018900849
SN - 0002-9149
VL - 45
SP - 197
EP - 202
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 2
ER -