Critical Reappraisal of Bedside Echocardiographic Parameters for Estimation of Left Ventricular Ejection Fraction in Acute Myocardial Infarction

Abstract

The relative value of simple bedside M-mode and two-dimensional échocardiographie indices and their combinations for the estimation of the left ventricular ejection fraction (LYEF) in a single, large group of patients with acute myocardial infarction (AMI) has never been reported. Therefore, 79 patients with AMI were studied by echocardiography and radionuclide angiography within 12 h during the 2nd week following AMI. Parameters of left ventricular function by traditional M-mode indices (dimensions, fractional shortening, mitral-septal distance), by two-dimensional parameters (wall motion index, LVEF by Baran and by a truncated cone model), by statistical integration and by subjective evaluation were compared with radionuclide LVEF by linear regression. There was a clear trend towards a better accuracy by subjective evaluation of LVEF as compared with single parameter two-dimensional and M-mode methods. However, this difference of accuracy was only statistically significant with regard to M-mode dimensional parameters (R2 = 0.80 versus R^2 = 0.49 to R^2 = 0.24, p < 0.05). Thus, estimates of the LVEF can be obtained by multiple échocardiographie approaches which are all moderately inaccurate. The combination of parameters (wall motion index and end-systolic dimension) increased accuracy, but did not reach statistical significance. Estimates of LVEF based on a wall motion index are obtained in virtually all patients and have the additional advantage of providing data on the regional function in the same échocardiographie examination, contrary to subjective estimates of LVEF. Therefore, despite its inaccuracy, wall motion analysis appears to be the best presently known échocardiographie method for bedside estimation of LVEF in AML

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

“…1). Our results are in accordance with previous prognostic studies concerning patients with acute myocar dial infarction [9,30], a mixed group of patients suspected of heart disease [13] and patients presenting to the emer gency room with cardiac-related symptoms [12], Together with the present they show that wall motion index is a useful predictor of mortality in various stages and catego ries of heart disease, and furthermore is superior to pre viously used predictors, e.g. mitral-septal separation and fractional shortening.…”

Survival and Prognosis: Investigation of Crataegus Extract WS 1442 in congestive heart failure (SPICE) — rationale, study design and study protocol

“…The use of a scale with descending scores corresponding to descending ventricular pump function ensures a reliable calculation of left ventricular ejection fraction (LVEF) []. A linear correlation between WMI and LVEF has been previously demonstrated []. WMI×0.3 results in a calculated LVEF value.…”

Usefulness of Exercise Echocardiography in Early Detection of Multivessel Coronary Artery Disease after Uncomplicated Myocardial Infarction

“…On the contrary, a good correlation between WMSI and resting radionuclide ejection fraction has been reported by Beming et al [25] early after MI. In line with the expe rience of Limacher et al [17], we found that in MVD patients exercise-induced ischemia was associated with a greater worsening of left-ventricular function than in pa tients with less widespread coronary disease although the difference in the two groups was only of borderline statis…”