The relationships of left ventricular ejection fraction, end-systolic volume index and infarct size to six-month mortality after hospital discharge following myocardial infarction treated by thrombolysis

Abstract

Ejection fraction, ESVI and IS measurements performed one to two weeks after MI can each predict six-month mortality. Ejection fraction was superior to the other two measurements. However, this study had limited power to detect independent significance of ESVI or IS.

Relationship of infarct size and severity versus left ventricular ejection fraction and volumes obtained from 99mTc-sestamibi gated single-photon emission computed tomography in patients treated with primary percutaneous coronary intervention

“…We have no explanations for the disagreement between those data and our results, although the shorter time interval between symptom onset and vessel reperfusion in our series could have affected more favourably the final infarct size of the potentially more severe anterior infarctions than that of the inferior or lateral ones [28]. In their population studied within 16 days of index infarction, Burns et al did not find a significant influence of infarct location on the relation between infarct size and LVEF or ESVi [3]. Conversely, in an echocardiographic study, McClements et al observed a lower LVEF for similar infarct size, assessed as extent of regional wall motion, in the anteroapical than in the other infarctions [29].…”

“…Moreover, a major advantage of gated SPECT over both gated blood pool and first-pass angiocardiography is that it can easily provide a quite reliable estimate of LV volumes. It was possible to demonstrate a linear relation between infarct size and both ED and ES volumes, and the relationship appears well comparable to EDVi, End-diastolic volume index; ESVi, end-systolic volume index; LVEF, left ventricular ejection fraction that registered in larger patient populations by other authors [3,8].…”

“…The relationship between perfusion infarct size and LVEF has previously been demonstrated using separate imaging modalities, mainly equilibrium or first-pass radionuclide angiocardiography [3,7,8,12]. However, since gated SPECT is the current state-of-the-art technique for myocardial perfusion imaging, it is difficult to justify either the administration of an additional amount of radioactive tracer or the acquisition of a separate study to obtain the LVEF.…”

“…In patients with recent myocardial infarction, resting left ventricular (LV) ejection fraction (EF) is known to be important for prognostic stratification [1,2,3]. Also, the final extent of the infarct scar has been demonstrated to have major prognostic implications [3,4].…”

“…Also, the final extent of the infarct scar has been demonstrated to have major prognostic implications [3,4]. Several studies have shown the value of infarct size measured using 99m Tc-sestamibi single-photon emission computed tomography (SPECT), its relationship with LV function and volumes and the importance of the mismatch between these parameters [3,4,5,6,7,8,9,10,11,12,13]. Furthermore, 99m Tc-sestamibi SPECT allows the assessment of infarct severity, and this parameter, which is related to the residual viability within the infarct area, has been shown to be important in predicting functional recovery [14,15,16,17].…”