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European Heart Journal 1984 5(3):210-217;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Early two-dimensional echocardiographic measurement of left ventricular ejection fraction in acute myocardial infarction

G. KAN, C.A. VISSER, K.I. LIE and D. DURRER

Department of Cardiology and Clinical Physiology, Wilhelmina Gasthuis, University of Amsterdam, and y the Interuniversity Cardiological Institute 1054 EG Amsterdam. The Netherlands

Received 5 July 1983; revised 1 September 1983; .

Requests for reprints to G. Kan, M.D., Dept. of Cardiology, Wilhelmina Gasthuis, Eerste Helmersstraat 104, 1054 EG Amsterdam, The Netherlands.

Abstract

Left ventricular volume and ejection fraction were measured by 2-dimensional echocardiography from 2 orthogonal apical long axis views in 90 patients admitted with acute transmural myocardial infarction. Results were correlated with worst Killip class during hospital stay, enzymatic infarct size (peak CK-MB) and mortality. We used two algorithms, a biplane area-length algorithm and a modification of Simpson's rule.

Both algorithms yielded essentially the same results: there were statistically significant trends towards higher end-diastolic and end-systolic volumes and lower ejection fraction with higher Killip-class. Ejection fraction was lower (P<0.01) in the 6 patients dying from cardiogenic shock (28.0± 7.8% v. 46.6±10.l% in survivors with the area–length algorithm; 28.1 ±6.2% v. 48.l±10.2% with modified Simpson's rule). In 5 patients dying from other causes ejection fraction was 460± 14.9% with the area-length method or 46.2±14.5% with Simpson's rule (not different from survivors).

Correlation with peak CK-MB was only modest, though statistically significant: the regression equation was: y= -0.39.x+54 (r=-0.35; P<0.01) with the area-length method: and y= -0.41x+55 (r= -0.37; P<0.01) with Simpson's rule.

Left ventricular ejection fraction measured at the bedside in patients with acute myocardial infarction, can provide useful clinical information. Patients likely to develop shock can be identified shortly after admission.

Key Words: Cross-sectional echocardiography • left ventricular ejection fraction • acute myocardial infarction


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