Comparison of two-dimensional echocardiography with gated radionuclide ventriculography in the evaluation of global and regional left ventricular function in acute myocardial infarction

Abstract

Two-dimensional echocardiography and gated radionuclide ventriculography were performed in 93 patients (66 men, 27 women; mean age 61 years) with 95 episodes of acute myocardial infarction within 48 hours and at 10 days after infarction. Electrocardiographic sites of infarction were: 35 anterior, 49 inferoposterior and 11 nonlocalized. Abnormal motion of the anterior wall, septum or apex was seen in 97 and 100% of anterior infarctions by radionuclide ventriculography and echocardiography, respectively. Abnormal motion of an inferior or posterior wall segment was seen in 91% of inferoposterior infarctions by echocardiography versus 61% seen by radionuclide ventriculography. Ejection fractions determined by echocardiography and radionuclide ventriculography correlated well (r = 0.82) and did not change from the first 48 hours to 10 days after infarction (0.48 +/- 0.14). Similarly, wall motion score showed minimal change from the first 48 hours to 10 days. In-hospital mortality was 37 and 42% in patients with an ejection fraction of 0.35 or less by echocardiography and radionuclide ventriculography, respectively. No mortality was seen in patients with an ejection fraction above 0.40 by either test. The echocardiographic wall motion score was also predictive of mortality (40 versus 2%; score less than or equal to 0.50 versus greater than 0.50). The 1 year mortality rate in the 81 short-term survivors was 17%. Mortality was lowest in patients with an ejection fraction above 0.49 or wall motion score above (0.79 (2 to 5%) and worse in those with an ejection fraction below 0.36 or wall motion score below 0.51 (36 to 63%) by either technique. Thus in acute myocardial infarction, echocardiography and radionuclide ventriculography provide a comparable assessment of left ventricular function and wall motion in anterior infarction. Echocardiography appears more sensitive in detecting inferoposterior wall motion abnormalities. Both techniques are capable of identifying subgroups of patients with a high risk of death during the acute event and with an equally high mortality rate over a 1 year follow-up period.

Intraoperative detection of myocardial ischemia in high-risk patients: electrocardiography versus two-dimensional transesophageal echocardiography.

“…We positioned the transducer behind the heart to obtain a short-axis, cross-sectional view of the left ventricle at the level of the papillary muscles ( figure 1, A) 17 The cross-sectional image was divided into quadrants with the papillary muscles as guides. This floating-reference system keyed to the papillary muscles compensated for translational and rotational movements of the heart.…”

Assessment of Left Ventricular Systolic Function Using Contrast Two-Dimensional Echocardiography With a High-Frequency Transducer in the Awake Murine Model of Myocardial Infarction.

“…In human echocardiography, the estimation of global cardiac function obtained by echocardiography has been validated by other methods, such as LV angiography 10,20,21 or gated single photon emission computed tomography. 20,[22][23][24][25] Recently, there has been successful measurement of LV volume in mice using a miniaturized conductance catheter, 26,27 gated magnetic resonance imaging, 28,29 biplane LV angiography 30 and radionuclide ventriculography, 31 the last method being used in murine hearts with an occluded left anterior descending artery. Although each of these techniques provided excellent accuracy, they are still not widely available and are technically demanding.…”

Prognostic Value of Echocardiography in 190 Patients with Chronic Congestive Heart Failure

“…However in recent years échocardio graphie estimation of left ventricular function has im proved [5][6][7]. Echocardiographie wail motion index is closely correlated to radionuclide-determined LVEF [7,8] and has been shown to carry strong prognostic informa tion in patients with acute myocardial infarction [8][9][10][11], in patients presenting to the emergency room with car diac-related symptoms [12] and in an unselectcd popula tion of patients suspected of heart disease [13], The prog nostic value of wall motion index was. however, never evaluated in a population with chronic congestive heart failure.…”