Clinical variables and the results of non-invasive tests (exercise test, echocardiogram, gated equilibrium radionuclide ventriculography and 24 h ECG) were recorded in a series of 202 patients who left the hospital alive after an acute myocardial infarction. The short term (two months) predictive value of all these data was prospectively assessed by uni- and multi-variate analysis. The best correlation with early death was observed with the variables related to the extent of infarction and left ventricular dysfunction, namely: early clinical signs of heart failure, high peak CK-MB level, complete bundle branch block, increased cardiothoracic ratio on chest X-Ray, number of Mets reached during the stress test, echocardiographic dyskinesia index, and decreased left ventricular ejection fraction as measured by radionuclide ventriculography. Using multi-variate stepwise discriminant analysis, the following independent prognostic factors appeared by order of entry: early clinical signs of heart failure, peak CK-MB level and cardiothoracic ratio on chest X-Ray. These results highlight the short-term predictive value of the data related to left ventricular dysfunction and especially of simple clinical data for patients surviving an acute myocardial infarction.

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Symposium on diagnostic methods in the study of left-to-right shunts. Circulation. 16 (791). 1957. KETY, S. S. Quantitative détermination of cérébral blood flow in man. Methods in Médical Research, vol. 1 (204i. The Year Book Publishers Inc.. Chicago. 1948. MORROW. A. G., R. J. SANDERS and E. BRAUNWALD. The nitrous oxide test : An improved method for the détection of left-to-right shunts. Circulation, 17 (284). 1958. SANDERS. R. J. and A. G. MORROW. The diagnosis of circulatory shunts by the nitrous oxide test. Improvements in technic and methods for quantification of the shunt. Circulation, 18 (856i. 1958.

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