Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Ejection fraction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1985

Videodensitometric ejection fraction from intravenous digital subtraction right ventriculograms: correlation with first pass radionuclide ejection fraction.

Thirty-one consecutive patients undergoing intravenous blurred mask digital subtraction right ventriculography were submitted to first pass radionuclide angiography. Second order mask resubtraction of end-diastolic and end-systolic right ventricular digital image frames was executed using preinjection end-diastolic and end-systolic frames to rid the digital subtraction images of mis-registration artifact. End-diastolic and end-systolic perimeters were drawn manually by two independent observers with a light pen. Ejection fractions calculated from the integrated videodensitometric counts within these perimeters correlated well with those derived from the first pass radionuclide right ventriculogram (r = 0.84) and the interobserver correlation was acceptable (r = 0.91). Interobserver differences occurred more frequently in patients with atrial fibrillation and in those whose tricuspid valve planes were difficult to discern on the digital subtraction right ventriculograms. These results suggest that videodensitometric analysis of digital subtraction right ventriculograms is an accurate method of determining right ventricular ejection fraction and may find wide clinical applicability.

Absorptiometry, Photon↗
PubMed2004

Development of a depressed left ventricular ejection fraction in patients with left ventricular hypertrophy and a normal ejection fraction.

The progression from concentric left ventricular (LV) hypertrophy to heart failure has not been well defined. Of 159 predominantly hypertensive African-American patients with LV hypertrophy and a normal ejection fraction (EF), 28 (18%) developed a reduced EF after a median follow-up of approximately 4 years. Risk factors for this outcome included a history of coronary artery disease, pulmonary edema seen on a chest x-ray, or a subsequent myocardial infarction.

Black or African American↗
PubMed1983

Work in progress: a correction for tissue iodine accumulation in videodensitometric measurements of left ventricular ejection fraction.

Left ventricular ejection fractions were determined following eight intravenous injections in three dogs using area/length and digital videodensitometric techniques. Ejection fractions were measured by both techniques for all beats during left ventricular opacification. Even after noniodinated background corrections, tissue iodine accumulation produced large errors in measured iodine content late in the contrast material curve. By using a model for tissue iodine accumulation, an algorithm was developed that appears to reduce these errors. The measured ejection fraction for ten beats following the peak of the contrast material curve declined an average of 1.8% following correction, compared with 14% prior to correction. Following correction for tissue iodine accumulation, correlation between area/length and video-densitometric ejection fractions was 0.94. By correcting for tissue iodine accumulation, much more of the contrast material curve provides usable data for estimating ejection fractions.

Absorptiometry, Photon↗
PubMed2000

Effect of coronary artery bypass surgery on myocardial perfusion and ejection fraction response to inotropic stimulation in patients without improvement in resting ejection fraction.

The aim of this study was to assess the effect of coronary artery bypass grafting (CABG) on myocardial perfusion and left ventricular (LV) contractile reserve in patients with reduced ejection fraction (EF). We studied 57 patients (age 59 +/- 8 years, 46 men and 11 women) with EF < or = 40% referred for CABG with dobutamine (up to 40 microg/kg/min) stress-reinjection thallium-201 single-photon emission computed tomography, and radionuclide ventriculography at rest and at low-dose dobutamine before and 3 months after CABG. An increase in resting EF > or = 5% occurred in 12 patients (group A) after CABG (EF 34% before and 46% after CABG), whereas no increase occurred in the remaining 45 patients (group B) (EF 34% before and 32% after CABG). A significant increase in EF from rest to low-dose dobutamine radionuclide ventriculography occurred before and after CABG. The magnitude of increase was more significant after than before CABG in group A (12% vs 7%) as well as in group B (13% vs 7%, both p <0.001). Patients in both groups had a significant reduction in stress, rest, and ischemic perfusion scores after CABG. However, the percentage of reduction in resting perfusion defect score was more significant in group A than in group B (60% vs 30%, respectively, p <0.01). It is concluded that CABG induces a significant improvement in resting myocardial perfusion and EF response to inotropic stimulation, even in the absence of improved EF at rest. Patients without improvement in resting EF after CABG have mild improvement in resting myocardial perfusion that may be sufficient to increase EF after CABG during inotropic stimulation, but not at rest. We describe the myocardium with these characteristics as "the reactive myocardium."

Cardiotonic Agents↗
PubMed2004

Clinical outcomes of patients with impaired left ventricular ejection fraction undergoing autologous bone marrow transplantation: can we safely transplant patients with impaired ejection fraction?

Experience with autologous bone marrow transplantation (ABMT) in patients with impaired left ventricular ejection fraction (LVEF) or heart failure (HF) is limited. We identified 308 consecutive patients who underwent ABMT for Hodgkin's or non-Hodgkin's lymphoma at our institution (1996-2003). Patient characteristics, clinical course and overall survival were compared between patients with preserved ( > or = 50%) or impaired ( < 50%) LVEF. Of the 308 patients identified, 20 had baseline impaired LVEF (four with LVEF < or = 40%, all NYHA class I-II HF). None of the patients with post-ABMT echocardiogram had worsened LVEF (n = 7). Among the 20 patients with impaired LVEF, four patients had reversible cardiac complications post-ABMT (including worsening HF). The two deaths observed in the impaired LVEF group were both due to noncardiac causes. The 5-year survival was similar between patients with preserved and impaired LVEF (P = 0.43). Careful selection of patients with stable, mild-to-moderate HF and impaired LVEF for ABMT can achieve similar long-term survival. As medical care for HF and ABMT improves, the exclusion criteria for ABMT with regard to HF and impaired LVEF should be re-examined.

Adult↗
PubMed1999

Three year mortality in heart failure patients with very low left ventricular ejection fractions.

BACKGROUND: Left ventricular ejection fraction is a predictor of the outcome in patients with chronic heart failure. Some treatments cause a small increase in ejection fraction and may, thereby, improve prognosis. METHOD: We studied 99 patients with heart failure and very low left ventricular ejection fractions (all < or =20%). Seventy-four patients had ejection fractions of 11-20% and 25 had < or =10%. Patient follow up was censored at three years. RESULTS: Mortality was 74% at three years. Left ventricular ejection fraction was not a predictor of mortality (P = 0.36). In contrast, peak VO2 at the beginning of the study was a strong predictor of outcome (P = 0.002). CONCLUSION: Three year survival is low when ejection fraction is very low. However, once the ejection fraction is < or =20% ejection fraction is no longer a predictor of mortality. These results suggest that it is unlikely that small increases in ejection fraction will be associated with a survival benefit in this group, and treatments aimed at increasing peak VO2 may be more appropriate.

Follow-Up Studies↗
PubMed1995

Pressure and volume loading of the right ventricle have opposite effects on left ventricular ejection fraction.

BACKGROUND: Left ventricular ejection fraction has been reported to be depressed in patients with right ventricular volume overload (RVVO) due to Ebstein's anomaly and uncomplicated atrial septal defect, whereas it is usually preserved in right ventricular pressure overload (RVPO) due to congenital pulmonic stenosis. In the present study, we examined the hypothesis that the differential timing of active displacement of the ventricular septum into the left ventricle in RVPO (end systole) and RVVO (end diastole) results in opposite effects of RVPO and RVVO on left ventricular ejection fraction. METHODS AND RESULTS: Ten patients with severe tricuspid regurgitation after tricuspid valve resection for endocarditis and 10 patients with primary pulmonary hypertension were studied as models of isolated RVVO and RVPO, respectively. Left ventricular ejection fraction, end-diastolic volume, and regional systolic shortening were measured with the use of echocardiographic techniques in these 20 patients and 10 healthy control subjects. In RVPO, despite marked underfilling of the left ventricle relative to the healthy control subjects (end-diastolic volume, 48 +/- 26 versus 77 +/- 20 mL; P < .02), left ventricular ejection fraction was similar to that of the control subjects (56 +/- 5% versus 60 +/- 4%; P = .07) and only 1 of 10 RVPO patients had an ejection fraction of less than 50%. In contrast, in RVVO the left ventricle was volume replete (end-diastolic volume, 84 +/- 26 versus 77 +/- 20 mL; P = NS), but left ventricular ejection fraction was significantly depressed (51 +/- 4% versus 60 +/- 4%, P < .001) compared with the control subjects, and 4 of 10 RVVO patients had an ejection fraction of less than 50%. Analysis of systolic fractional shortening along two perpendicular short-axis diameters and the mutually orthogonal long axis demonstrated isolated augmentation of fractional shortening in the ventricular septal-to-posterolateral free wall dimension in RVPO (47.4 +/- 13.7% versus 34.2 +/- 13.1%, P < .05) and isolated depression of fractional shortening along that same dimension in RVVO (13.7 +/- 11.8% versus 34.2 +/- 13.1%, P < .001) compared with the control subjects. CONCLUSIONS: End-systolic leftward ventricular septal shift in RVPO results in isolated augmentation of systolic shortening in the septal-to-free wall dimension, whereas end-diastolic leftward ventricular septal shift in RVVO results in isolated reduction in systolic shortening in the septal-to-free wall dimension. As a result, despite relative underfilling of the left ventricle in RVPO, resting left ventricular ejection fraction is preserved, whereas ejection fraction is depressed for the volume-replete left ventricle of patients with RVVO.

Adolescent↗
PubMed2001

Comparison of echocardiography with technetium 99m-gated single photon emission computed tomography as diagnostic tools for left ventricular ejection fraction.

Left ventricular ejection fractions (LVEF) are routinely measured and result in critical decision-making algorithms in cardiology. This study was conducted to compare the accepted standard two-dimensional (2-D) echocardiogram ejection fraction (EF(ECHO)) with single photon emission computed tomography rest ejection fraction (EF(SPECT)). Data were acquired and analyzed from 51 inpatients. EF(ECHO) was obtained using modified Simpson's rule in the four-chamber apical view, and gated EF(SPECT) was computed by an automated method (Siemens ICON software). Comparison between EF(ECHO) and EF(SPECT) was done by linear regression, Bland-Altman, and receiver operator characteristic (ROC) analyses. Linear regression analysis revealed EF(SPECT) = 1.12 x EF(ECHO) - 3.6%, r = 0.93, n = 51, P < 0.0001. Bland-Altman analysis showed that the limits of 95% confidence for the difference between EF(SPECT) and EF(ECHO) were - 12% to 18%. Ninety-eight percent of the datapoints were within the limits of confidence. The ROC analysis showed that the sensitivity and specificity for detecting abnormal EF (< or = 50%) were 85% and 86% with EF(SPECT), and 91% and 90% with EF(ECHO). This study showed good correlation as well as agreement between SPECT and two-dimensional echocardiograms in measuring EF.

Coronary Artery Disease↗
PubMed1991

Factors determining improvement in left ventricular function after reperfusion therapy for acute myocardial infarction: primacy of baseline ejection fraction.

Improvement in left ventricular ejection fraction is a measure of salvage of ischemic myocardium after reperfusion therapy for acute myocardial infarction. The degree of improvement in left ventricular ejection fraction may be influenced by many factors. Therefore, 137 patients in whom paired radionuclide angiograms were obtained within 24 h of acute infarction and before hospital discharge were retrospectively evaluated to determine which factors most affect improvement in ejection fraction. Only baseline ejection fraction correlated significantly with improvement in ejection fraction by both univariate analysis (ejection fraction as a continuous variable; p less than 0.001; ejection fraction as a categorical variable, less than or equal to 45% versus greater than 45%, p less than 0.0001) and multivariate analysis (p less than 0.0001). Reperfusion status (patent versus occluded infarct artery) and extent of coronary artery disease (one, two or three vessel) were significant factors by multivariate but not by univariate analysis. Location of infarction, treatment modality and time to treatment did not correlate with change in ejection fraction by either statistical technique. Thus, of those factors tested, baseline left ventricular ejection fraction is the most potent predictor of improvement in ventricular function after acute infarction. Knowledge of baseline ejection fraction may be helpful in deciding whether to treat some patients with equivocal indications or contraindications for reperfusion therapy. Clinical trials of reperfusion strategies should stratify patients on the basis of baseline ejection fraction if ejection fraction is to be used as an end point for myocardial salvage.

Adult↗
PubMed1995

Two-dimensional echocardiographic evaluation of left ventricular ejection fraction by the ellipsoid single-plane algorithm: a reliable method for assessing low or very low ejection fraction values?

The reliability of two-dimensional (2D) echocardiographic estimation of left ventricular ejection fraction (EF) is commonly recognized, but no satisfactory data are available about the accuracy of low or very low EF values determined by 2D echocardiography (ECHO-EF). The purpose of our study was to assess the reliability of low ECHO-EF values obtained using a simple time-economical algorithm such as the ellipsoid single-plane area-length method. Radionuclide angiography (RAD-EF) was taken as the standard of comparison. We studied 59 consecutive patients (31 women and 28 men) referred to our echocardiographic laboratory. Both 2D echocardiography and radionuclide angiography were blindly performed within 48 h of one another. EF was calculated by the two methods and then compared. Data were globally analyzed. Furthermore, data were divided and analyzed according to the ECHO-EF cut-off point of 50%. An ECHO-EF value of 50% was chosen to conventionally distinguish between low ECHO-EF values and normal-high ones. Data were plotted, and the line of equality and the regression lines were drawn. Regression line slopes, correlation coefficients, means and standard deviations were calculated. The agreement was analyzed by calculating the mean difference (RAD-EF-ECHO-EF) and the standard deviation of the differences. ECHO-EF was linearly related to RAD-EF even when data were split. In particular, as regards ECHO-EF < or = 50%, the regression line practically overlapped the line of equality, and the two methods showed both a strong correlation and a good degree of agreement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Identification of ultrasound contrast agent dilution systems for ejection fraction measurements.

Left ventricular ejection fraction is an important cardiac-efficiency measure. Standard estimations are based on geometric analysis and modeling; they require time and experienced cardiologists. Alternative methods make use of indicator dilutions, but they are invasive due to the need for catheterization. This study presents a new minimally invasive indicator dilution technique for ejection fraction quantification. It is based on a peripheral injection of an ultrasound contrast agent bolus. Left atrium and left ventricle acoustic intensities are recorded versus time by transthoracic echocardiography. The measured curves are corrected for attenuation distortion and processed by an adaptive Wiener deconvolution algorithm for the estimation of the left ventricle impulse response, which is interpolated by a monocompartment exponential model for the ejection fraction assessment. This technique measures forward ejection fraction, which excludes regurgitant volumes. The feasibility of the method was tested on a group of 20 patients with left ventricular ejection fractions going from 10% to 70%. The results are promising and show a 0.93 correlation coefficient with echographic bi-plane ejection fraction measurements. A more extensive validation as well as an investigation on the method applicability for valve insufficiency and right ventricular ejection fraction quantification will be an object of future study.

Algorithms↗
PubMed1995

Prediction of long-term survival by preoperative exercise testing in patients with depressed ejection fraction undergoing myocardial revascularization.

Ejection fraction is a major determinant of morbidity and mortality for patients with ischemic heart disease. Patients with an ejection fraction of 0.40 or less are generally recognized as having a poorer prognosis than those patients with an ejection fraction of 0.50 or better and remain a heterogeneous group. It would be useful if patients with a favorable surgical prognosis could be identified preoperatively. Fifty-five patients who underwent coronary artery bypass grafting and had an ejection fraction less than 0.40 (mean of 0.23 +/- 0.07 standard deviation) were studied by catheter measurement of pulmonary arterial pressure and radionuclide left ventriculography. Heart rate, systemic blood pressure, pulmonary artery pressures, cardiac output, and ejection fraction were measured, at rest, after nitroglycerin was given intravenously and with supine bicycle exercise. Forty-seven patients who had follow-up longer than 4 years were divided into two groups according to their life status (alive or dead) 4 years after operation. Measured variables of exercise stress tests and clinical characteristics were entered into factor analysis to obtain a cardiac function factor score for predicting the life status after 4 years. The cardiac function factor score was highly loaded by stroke index (rest, nitroglycerin), cardiac index (exercise), systemic vascular resistance index (exercise), and history of congestive heart failure. The cardiac function factor provided a predictive value superior to that of any individual variable. By dividing the patients into two groups by cardiac function factor score, the actuarial 5-year survival was 72% versus 17% for good and poor prognosis groups, respectively (p < 0.0001). Preoperative exercise stress testing data integrated by factor analysis provide a predictive tool for patients with a low ejection fraction.

Adult↗
PubMed1977

Sudden death in the year following myocardial infarction. Relation to ventricular premature contractions in the late hospitals phase and left ventricular ejection fraction.

Both depressed left ventricular ejection fraction and ventricular arrhythmias have been associated with a poor prognosis following acute myocardial infarction. To assess the relative role of each of these parameters in predicting mortality in the early period after hospitalization for myocardial infarction, 24 hour ambulatory electrocardiographic tape recordings and gated cardiac blood pool scans were obtained in 81 patients approximately two weeks after their admission to the hospital for myocardial infarction. Lown class 0 to II ventricular premature contractions during this period were classified as uncomplicated ventricular arrhythmias and Lown class III to V ventricular premature contractions were classified as complicated ventricular arrhythmias. Ejection fraction was calculated from biplane images of gated cardiac blood pool scans. In 35 patients the ejection fraction was greater than or equal to 0.40; only three of these had complicated ventricular arrhythmias. In 45 patients the ejection fraction was less than 0.40; 26 of these had complicated ventricular arrhythmias. Eight patients had documented ventricular fibrillation or instantaneous death during a mean 7.0 moonth (range 2 to 16 months) follow-up period outside the hospital. Although the number of patients studied was small, and there were only eight sudden deaths, life table analysis projected a one year mortality of 66 per cent in patients with complicated ventricular arrhythmias and 31 per cent in patients with an ejection fraction less than 0.40. All eight patients who died suddenly were in the subgroup of 26 patients with an ejection fraction less than 0.40 and complicated ventricular arrhymias; none was in the subgroup of 19 patients with an ejection fraction less than 0.40 and uncomplicated ventricular arrhythmias (P less than 0.02). Although a low ejection fraction may suggest a poor prognosis following myocardial infarction, the presence of complicated ventricular arrhythmias significantly increases the risk of sudden cardiac death in the early period after hospitalization in patients with low ejection fraction.

Arrhythmias, Cardiac↗
PubMed1989

Factor analysis of multigated cardiac blood pool scintigram for the measurement of left ventricular ejection fraction.

Left ventricular ejection fraction (EF) was measured by factor analysis (FA) of multigated cardiac blood pool scintigram in 38 consecutive patients, and compared with that measured by the variable ROI method (EFVROI) with automated left ventricular contour detection. FA was automatically performed without operator intervention with a success rate of 100%. The correlation of EF with EFVROI was significant in the group of 22 patients with normal wall motion (r = 0.65, p less than 0.001), and the entire group of patients (r = 0.70, p less than 0.001), but not significant (p = 0.19) in the group of 16 patients with abnormal wall motion. In conclusion, left ventricular ejection fraction can be estimated by factor analysis of MUGA in patients with normal wall motion.

Adult↗
PubMedDate not supplied

Factors that predict improvement in left ventricular ejection fraction after coronary angioplasty for acute myocardial infarction.

Acute and follow-up angiograms were analyzed in 75 patients with acute myocardial infarction treated with emergency coronary angioplasty to determine factors that might predict improvement in left ventricular ejection fraction. Ejection fraction improved 8.4 +/- 8.2% in 60 patients who maintained patent infarct vessels at follow-up angiography, compared with -4.1 +/- 6.0% in 15 patients who developed reocclusion (p less than .001). In patients with patent infarct vessels, univariate analysis revealed the following significant predictors of improvement in ejection fraction: initial ejection fraction (r = -.38, p less than .003) subtotal vs total stenosis (12.9 +/- 9.3% vs 6.9 +/- 7.3%, p less than .02), infarct vessel (left anterior descending 11.0 +/- 8.4%, right 6.8 +/- 6.4%, circumflex 2.6 +/- 7.5%, p less than .02), and time to follow-up study (less than or equal to 15 days vs greater than 15 days) (4.8 +/- 5.8% vs 9.8 +/- 8.6%, p less than .03). Reperfusion time (less than or equal to 2 hr vs greater than 2 hr) predicted improvement when subtotal stenoses and stuttering infarctions were excluded (10.6 +/- 7.0% vs 4.9 +/- 6.9, p less than .03). Multivariate analysis showed initial ejection fraction and subtotal vs total stenosis to be independent predictors. Patients with anterior infarctions, low initial ejection fractions, and subtotal stenoses or reperfusion times less than or equal to 2 hr are likely to benefit most from coronary angioplasty for acute myocardial infarction.

Angioplasty, Balloon↗
PubMed1990

The nature of the background in radionuclide ventriculography: deductions from the mathematical behaviour of the ejection fraction.

The relationship between the ejection fractions calculated from 'uncorrected' radionuclide time activity curves (UEF) and angiographic ejection fractions (AEF) in 200 catheterized patients yielded the regression equation AEF = 1.74 UEF + 0.21. It follows from this linear relationship that the left ventricular ejection fraction can be estimated by linear regression without explicit background correction: RREF = 1.74 UEF + 0.21, where RREF is the radionuclide regression ejection fraction. We first investigated the possibility that changes in photon self-attenuation within the cardiac chambers cause the observed mathematical characteristics of the cardiac background, B. Self-attenuation was calculated for cylindrical and spherical ventricular models. The results were insensitive to the particular geometry and would have only a small effect on the observed EF. Alternatively, the 'background' may result from extra-ventricular radiation scattering from the heart into the detector. If we assume that B should be proportional to the ventricular scattering volume, Bd = Kd EDC for diastole and Bs = Ks ESC for systole, the background corrected ejection fraction will be BCEF = K UEF + (1-K) where K = (1-Ks)/(1-Kd). This agrees with the form of the empirical regression equation.

Biophysical Phenomena↗
PubMed1996

Death, mode of death, morbidity and requirement for rehospitalization during 2 years after coronary artery bypass grafting in relation to preoperative ejection fraction.

OBJECTIVE: To describe the impact of ejection fraction on the prognosis during 2 years after coronary artery bypass grafting (CABG). PATIENTS: All patients in western Sweden who underwent CABG without concomitant valve surgery between June 1988 and June 1991. RESULTS: In all, 2121 patients were operated upon and information on ejection fraction was available for 1961 patients (92%). Of these patients, 178 (9%) had an ejection fraction < 40%, 517 (26%) an ejection fraction of 40-59% and 1266 (65%) an ejection fraction > or = 60%. In these groups the mortalities during the first 30 days after CABG were 5.1, 4.3 and 2.2%, respectively (P < 0.01). The corresponding values for mortalities between 30 days and 2 years were 7.7, 4.3 and 3.3%, respectively (P < 0.01). Patients with a lower ejection fraction were more frequently men and more frequently had a history of cardiovascular disease. In multivariate analysis the preoperative ejection fraction was an independent predictor for total 2-year mortality. Patients with a low ejection fraction died more frequently in association with ventricular fibrillation. Morbidity was, with the exception of that for rehospitalization due to heart failure and infection, not associated significantly with the preoperative ejection fraction. CONCLUSION: During the 2 years after CABG a low preoperative ejection fraction was associated with a higher mortality, but the association with morbidity was more complex.

Adult↗