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 361 records · Page 20Linked to original sources
PubMed1992

Technetium-99m sestamibi myocardial imaging at rest for assessment of myocardial infarction and first-pass ejection fraction. Multicenter Cardiolite Study Group.

The ability of technetium (Tc)-99m sestamibi myocardial perfusion imaging at rest to evaluate myocardial infarction and first-pass ejection fraction was studied in a trial involving 18 institutions. Protocol I compared regional perfusion with occurrence of infarction by Q wave or by gated blood pool scan wall motion abnormality in 146 patients. Protocol II assessed first-pass right and left ventricular ejection fraction in 85 patients. In protocol I, Tc-99m sestamibi images were abnormal in 104 of 111 patients (94%) with both a Q wave and a gated scan wall motion abnormality and was normal in 23 of 25 patients (92%) in whom both were normal. Therefore, concordance existed in 105 (94%) patients. Of 115 patients with a Q wave, 107 (93%) had an abnormal Tc-99m sestamibi study. Of 115 patients with a gated scan wall motion abnormality, 108 (94%) had an abnormal Tc-99m sestamibi study. Tc-99m sestamibi imaging showed corresponding perfusion abnormalities in 81% of 69 anterior Q-wave infarcts, 73% of 55 inferior Q-wave infarcts and 88% of 8 posterior infarcts. Specificity in normal regions on electrocardiography and wall motion was 91, 100 and 100%, respectively, for anterior, inferior and posterior regions, respectively, between wall motion and perfusion. Of 17 myocardial segments per patient, there was concordance in 74% of patients. First pass Tc-99m sestamibi imaging of ejection fraction agreed well with conventional first-pass imaging for the right and left ventricle. It is concluded that Tc-99m sestamibi myocardial imaging at rest reliably diagnoses and localizes infarction and assesses ejection fraction by first-pass imaging.

Adult↗
PubMed1996

Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction. Results of a two-year follow-up study.

OBJECTIVES: The aim of this study was to compare the predictive value of mean RR interval assessed from predischarge Holter recordings with that of heart rate variability and left ventricular ejection fraction for risk stratification after myocardial infarction. BACKGROUND: Heart rate variability is a powerful tool for risk stratification after myocardial infarction. Although heart rate variability is related to heart rate, little is known of the prognostic value of 24-h mean heart rate. METHODS: A total of 579 patients surviving the acute phase of myocardial infarction were followed up for at least 2 years. Predischarge heart rate variability, 24-h mean RR interval and left ventricular ejection fraction were analyzed. RESULTS: During the first 2 years of follow-up, there were 54 deaths, 42 of which were cardiac (26 sudden). Shorter mean RR interval was a better predictor of all-cause mortality as well as cardiac and sudden death than depressed left ventricular ejection fraction. Depressed heart rate variability predicted the risk of death better than mean RR interval for sensitivities < 40%. For sensitivities > or = 40%, mean RR interval was as powerful as heart rate variability. All three variables performed equally well in predicting nonsudden cardiac death. For cardiac death prediction, a left ventricular ejection fraction < 35% had a 40% sensitivity, 78% specificity and 14% positive predictive accuracy; a mean RR interval < 700 ms had a 45% sensitivity, 85% specificity and 20% positive predictive accuracy; and a heart rate variability < 17 U had a 40% sensitivity, 86% specificity and 20% positive predictive accuracy. CONCLUSIONS: Predischarge 24-h mean heart rate is a strong predictor of mortality after myocardial infarction that can compete with left ventricular ejection fraction and heart rate variability.

Cohort Studies↗
PubMed1983

Global and regional left ventricular ejection fraction abnormalities during exercise in patients with silent myocardial ischemia.

Sixteen asymptomatic patients with coronary artery disease and silent myocardial ischemia were studied with exercise radionuclide ventriculography. Radionuclide ventriculograms were analyzed for changes in ejection fraction globally and in three regions. Results were compared with radionuclide ventriculograms in 24 symptomatic patients. Both groups (silent myocardial ischemia and angina) were similar in prevalence of multivessel disease and previous myocardial infarction, as well as in age and sex. Global ejection fraction decreased by 0.06 in both groups during exercise; regional ejection fraction also decreased by similar amounts in the two groups. Furthermore, the percent of regions with normal ejection fraction at rest that demonstrated a decrease during exercise was identical: 19 (60%) of 33 versus 26 (60%) of 46. These exercise radionuclide ventriculographic results suggest that abnormalities in regional and global left ventricular wall motion are similar in patients with coronary artery disease with and without silent myocardial ischemia.

Angiography↗
PubMed1997

Determination of ventricular ejection fraction: a comparison of available imaging methods. The Cardiovascular Imaging Working Group.

Knowledge of left ventricular ejection fraction has been shown to provide diagnostic and prognostic information in patients with known or suspected heart disease. In clinical practice, the ejection fraction can be determined by using one of the five currently available imaging techniques: contrast angiography, echocardiography, radionuclide techniques of blood pool and first pass imaging, electron beam computed tomography, and magnetic resonance imaging. In this review, we discuss the clinical application as well as the advantages and disadvantages of each of these methods as it relates to determination of ventricular ejection fraction.

Angiocardiography↗
PubMed2004

Comparison between tagged MRI and standard cine MRI for evaluation of left ventricular ejection fraction.

Global left ventricular function is a prognostic indicator and is used to evaluate therapeutical interventions in patients with heart failure. Regional left ventricular function can be determined with tagged MRI. Assessment of global left ventricular function using the tagging data may have additional clinical value without incurring extra scanning time, which is currently a limiting factor in cardiac imaging. Direct determination of end-diastolic volume is not possible with conventional tagged MRI. However, end-systolic volume can be directly measured because myocardium-blood contrast improves through a tagged image series. We investigated the potential of tagged MRI using frequency-domain analysis software to retrospectively track end-diastolic contour from end-systolic contour and subsequently calculate the ejection fraction. Tagged MRI was compared with the standard bright-blood cine MRI in healthy volunteers ( n=20) and patients with previous myocardial infarction ( n=8). Left ventricular ejection fraction derived from tagged MRI is linearly correlated to left ventricular ejection fraction obtained by standard cardiac cine MRI ( y=1.0 x+1.31, r>0.98, p=0.014). In addition, the inter-observer and intra-observer coefficient of variation for left ventricular ejection fraction measurements was low (CV(intra)=0.4%, CV(inter)=1.3%). With tagged MRI, only end-systolic volume needs to be manually determined, and accurate estimation of left ventricular ejection fraction is obtained because end-diastolic and end-systolic volumes are determined using identical anatomical points. Our data indicate that tagged MRI can be used to quantitatively assess both regional and global left ventricular function. Therefore, tagged MRI may be a valuable clinical tool for determining the prognosis and evaluating the effect of therapeutical intervention using a single imaging session in patients with left ventricular dysfunction.

Humans↗
PubMed1978

Radionuclide angiocardiography, a noninvasive method for evaluating left ventricular ejection fraction and regional wall motion; comparison with contrast left ventricular angiography.

The efficacy of gated synchronous acquisition (GSA) after cardiac blood pool labelling in assessing left ventricular function (ejection fraction and regional wall motion) was evaluated in 31 patients within 24 hours of contrast left ventricular angiography. With the R-wave of the electrocardiogram as a physiologic marker, radionuclide data recorded into an on-line computer allowed construction of cardiac blood pool images during sequential periods of the cardiac cycle. The images, of high count density, have good spatial resolution and can be viewed repetitively in real time in a cine mode. The ejection fractions calculated from the left ventricular time-activity curves corrected for background activity correlated well with the ejection fractions determined from dimension analysis of the contrast left ventricular angiograms (r = 0.87). The results were highly reproducible (r = 0.97). Results of analysis of left ventricular wall motion were similar with the two types of angiograms in 26 of the 31 subjects. GSA is a simple, safe means of evaluating left ventricular ejection fraction and regional wall motion noninvasively.

Angiocardiography↗
PubMed1996

Prognostic value of predischarge exercise testing, ejection fraction, and ventricular ectopic activity in acute myocardial infarction treated with streptokinase.

The relative importance of prognostic parameters that delineate left ventricular function, myocardial ischemia, and arrhythmogenic potential after thrombolytic therapy is not clear. This study investigated 112 patients with acute myocardial infarction who were treated with thrombolysis to determine the relative prognostic value of predischarge treadmill exercise testing, radionuclide ventriculography, and ambulatory electrocardiographic monitoring for ventricular ectopic activity. During a mean follow-up period of 18 months (range 6 to 30), 42 first cardiac events were recorded, consisting of 3 deaths, 6 reinfarctions, 16 bouts of unstable angina, 16 episodes of heart failure, and 1 arrhythmic event. Univariate analysis revealed ejection fraction, exercise time, and ventricular ectopic count of > or = 10/hour to be predictive of future cardiac events. Subsequent multivariate analysis showed ejection fraction (p <0.001) and exercise time (p=0.002 to have independent prognostic value, but ventricular ectopic activity did not provide additional information. Ventricular ectopic count > or = 10/hour was additionally predictive only when combined with either ejection fraction (R2=5.4%) or exercise time (R2=2.9%). Event-free survival analysis revealed hazard ratios for ejection fraction <40% and exercise time <7 minutes of 3.63 (p=0.001) and 2.16 (p=0.01), respectively. Although ejection fraction and exercise time were able to predict future episodes of heart failure, neither could adequately identify patients at risk of recurrent ischemic events.

Aged↗
PubMed1979

Comparison of left ventricular ejection fraction by EKG-gated radionuclide techniques and contrast angiography using a microcomputer system.

The left ventricular ejection fractions of 53 patients were determined from multi-image cardiac blood pool scintigrams in the left anterior oblique position utilizing a microcomputer and floppy disc. These data were compared to ejection fractions obtained at cardiac catheterization in the right anterior oblique position. The ejection fraction obtained by radionuclide technique was comparable to that obtained by contrast angiography in the 53 patients with an r = 0.93. Forty-five patients with coronary artery disease showed an r = 0.92. In the coronary artery group with regional wall dysfunction, the correlation was r = 0.89.

Angiography↗
PubMed1983

Reassessment of the relation between QRS forces of the orthogonal electrocardiogram and left ventricular ejection fraction.

Previous studies have demonstrated the existence of a strong positive correlation between the amplitude of QRS forces of the orthogonal electrocardiogram and the angiographically determined left ventricular ejection fraction. In a large group of patients evaluated for chest pain, we examined the relationship between the arithmetic summation of RX + RY + QZ (sigma R), the maximal and mean spatial QRS vectors and the ejection fraction (EF). In a total of 252 patients, there was a statistically significant correlation between sigma R and EF but a low correlation coefficient value (r:0.22, P less than 0.001). This relationship was essentially due to the group of patients with coronary artery disease and myocardial infarction (r:0.24, P less than 0.015) whereas there was no correlation in the group of normal subjects or in patients with coronary artery disease without myocardial infarction. In the group with myocardial infarction, a significant correlation between sigma R and EF existed only in patients with anterior myocardial infarction (r:0.41, P less than 0.025). In conclusion, both ejection fraction and amplitude of QRS forces decrease in coronary artery disease especially when an anterior myocardial infarction is present. However, despite the positive association between these angiographic and electrocardiographic indices, the low value of the correlation coefficient indicates that it is not possible to predict ejection fraction from the value of sigma R in individual patients.

Cardiac Catheterization↗
PubMedDate not supplied

Regional ejection fractions in patients with patent and thrombosed grafts after coronary artery vein bypass surgery.

Twenty-six patients who had received 43 grafts were studied before and after coronary artery vein bypass surgery. Cine ventriculograms taken in the right anterior oblique projection were analyzed and regional ejection fractions calculated. Single and multiple grafts were considered separately as were thrombosed and patent grafts. Patients were also divided into those with regional ejection fractions below 50% and those with regional ejection fractions above 50%. No statistically significant improvement of the relevant segments was demonstrated in any group. However, those with a regional ejection fraction above 50%, whose grafts had thrombosed, deteriorated from a mean of .66 to .39. There is a significant trend here (p less than .05) and a t test significance at the 7% level.

Cineangiography↗
PubMed1984

Noninvasive diagnosis of pulmonary arterial hypertension in chronic obstructive pulmonary disease: right ventricular ejection fraction at rest.

Because right ventricular ejection fraction (RVEF) depends on impedance to RV ejection, the hypothesis was tested that an abnormality in radionuclide-determined RVEF would be a useful noninvasive predictor of pulmonary artery (PA) hypertension in patients with chronic obstructive pulmonary disease (COPD). Simultaneous measurements of resting RVEF and PA pressure were made in 30 patients with COPD. All were stable and without clinical evidence of respiratory decompensation or congestive heart failure. Eleven patients had normal (less than 20 mm Hg) mean PA pressure and 19 patients had PA hypertension. The average RVEF was 41 +/- 7% (range 29 to 60%). Five patients had normal (greater than 45%) and 25 patients depressed RVEF. An inverse linear relation between mean PA pressure and RVEF was present (r = -0.74). In the group with normal PA pressure, RVEF averaged 48% (range 42 to 60%). In the group with PA hypertension, RVEF averaged 36% (range 29 to 44%). RVEF was significantly higher in the group with PA hypertension. Using RVEF less than 45% as an indicator of PA hypertension, the sensitivity was 100%, the specificity 55%, and the predictive accuracy of a positive result 79%. Using RVEF less than or equal to 40% as an indicator of PA hypertension, the sensitivity was 75%, the specificity 100%, and the predictive accuracy of a positive study 100%. Thus, radionuclide-determined RVEF using the first-pass technique and a multicrystal camera is a useful noninvasive test for diagnosing PA hypertension in patients with advanced COPD.

Adult↗
PubMed1984

Relation between exercise-induced changes in ejection fraction and systolic loading conditions at rest in aortic regurgitation.

To examine the role of systolic wall stress at rest in determining left ventricular performance during exercise in aortic regurgitation (AR), systolic wall stress (measured by M-mode echocardiography) was related to changes in left ventricular function during maximal exercise (evaluated by radionuclide ventriculography) in 30 patients with chronic aortic regurgitation. Of these 30 patients, 7 had a normal exercise response, defined as an absolute increase in ejection fraction of 5% or greater (Group I) and 23 had abnormal exercise response, defined as no change (less than 5% change) or a decline (less than or equal to 5%) in ejection fraction (Group II). Patients in Group I had a significantly lower radius/wall thickness ratio (2.5 +/- 0.2 versus 3.1 +/- 0.1, p less than 0.01) and lower peak systolic wall stress (123 +/- 11 versus 211 +/- 12 X 10(3) dynes/cm2, p less than 0.01) than patients in Group II. An increase in ejection fraction during exercise was seen in 6 of the 9 patients with normal systolic wall stress at rest (less than 150 X 10(3) dynes/cm2), but in only 1 of 21 patients with elevated systolic wall stress (p less than 0.001). Peak systolic wall stress at rest varied linearly, and inversely with changes in left ventricular ejection fraction during exercise (r = 0.60, p less than 0.001). Groups I and II did not differ in ejection fraction at rest, clinical symptoms or maximal work load achieved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1969

Fiber orientation and ejection fraction in the human left ventricle.

Fiber orientation and ventricular geometry are incorporated in a mathematical model for ejection fraction of the human left ventricle. The inadequacy of circularly oriented or "constrictor" fibers to explain high ejection fractions of cylindrical, spherical, or ellipsoidal reference ventricles is demonstrated. A class of "helical" fibers is then introduced from which ejection fractions predicted by physiologic amounts of fiber shortening on cylindrical and ellipsoidal reference ventricles are shown to be consistent with those calculated from biplane angio-cardiographic films.

Heart↗
PubMed1988

Correlation of right and left ventricular ejection fraction and volume measurements.

First-pass radiocardiography and biplane angiocardiography were performed on 13 patients with left-sided regurgitant valvular disease (R+) and 7 patients without regurgitation but with coronary artery disease and/or cardiomyopathy (R-). Right and left ventricular volumes and ejection fractions were calculated and compared. In the R- group, corresponding right and left ventricular volumes and ejection fractions correlated highly with each other (r = 0.86-0.89, p approximately equal to 0.01). Ejection fractions in the R+ group correlated (r = 0.64, p less than 0.05) only because stroke volume correlation was very high (r = 0.93), with end-diastolic and end-systolic volumes showing no significant correlation. Right ventricular ejection fraction (RVEF) decreased significantly with increasing mean pulmonary artery pressure (PAP) in both R- and R+ groups. The correlation of RVEF and LVEF in the R- group appears to be multifactorial in origin, consisting of effects of increased PAP, the mechanical interference of an enlarged left ventricle on the right ventricle, and direct biventricular ischemic effects. In the R+ group, the correlation appears to be due to only increased PAP and its sequelae.

Angiocardiography↗
PubMed1990

Comparison of ejection fraction and Goldman risk factor analysis to dipyridamole-thallium 201 studies in the evaluation of cardiac morbidity after aortic aneurysm surgery.

Associated coronary artery disease is the critical factor that influences early and late mortality after abdominal aortic aneurysm surgery. Dipyridamole-thallium 201 scintigraphy, left ventricular ejection fraction, and Goldman risk factor analysis have been suggested as preoperative noninvasive screening methods to detect significant coronary artery disease. In this series of 95 elective abdominal aortic aneurysm repairs dipyridamole-thallium 201 scintigraphy was highly predictive of the absence of perioperative cardiac morbidity (96% specificity, 44/46 normal scans, no cardiac morbidity), whereas ejection fraction (73% specificity, 31/42 normal ejection fraction, no cardiac morbidity) and Goldman risk factor analysis (84% specificity, 44/51 class I, no cardiac morbidity) were less. Furthermore, thallium redistribution on dipyridamole-thallium 201 scintigraphy leading to coronary angiography identified a significant number of patients with occult coronary artery disease who required preoperative coronary revascularization (8%, 8/95) and might have remained undetected on the basis of left ventricular ejection fraction or Goldman risk factor analysis. Finally, fixed thallium deficit, which some investigators have interpreted as a low probability finding for cardiac morbidity, was associated with a higher than expected incidence of cardiac complications. Forty-six percent (7/15) of all postoperative cardiac complications (three myocardial infarctions, three ischemic events, one death) occurred in patients with abdominal aortic aneurysms with fixed deficits. This suggests that patients with fixed deficits on dipyridamole-thallium 201 scintigraphy should be considered for later "delayed" (4 hours) thallium images or coronary angiography or both.

Aged↗
PubMed1979

Effect of exercise on left ventricular ejection fraction in men with coronary artery disease.

Left ventricular ejection fraction (LVEF) was measured at rest and during supine bicycle exercise in 31 men with arteriographically defined coronary disease and in 15 normal men. LVEF was calculated from a left ventricular time vs activity curve (collimated scintillation probe, 99m Technetium) as the fracitonal fall in count-rate divided by the background-corrected left ventricular end-diastolic count-rate. In normal men LVEF at rest averaged .59 +/- .06 (+/-SD) and during exercise was .72 +/- .08. LVEF did not increase with exercise in men with coronary disease (.55 +/- .03 to .57 +/- .03; N = 31; AVE +/-SEM; NS). In 17 men with coronary disease who had ST segment depression with exercise, LVEF either decreased or was unaltered in all (55 +/- .04 to .49 +/- .03; P less than 0.05); whereas in 14 without ST depression, LVEF increased in 10 (71 per cent) and was unaltered in 4 (29 per cent) (.54 +/- .04 to .66 +/- .04; P less than 0.01). Results suggest that LVEF during exercise normally increases, but in men with coronary disease LVEF either fails to increase or actually decreases. In addition there appears to be a relationship between ST segment changes during exercise and ejection fraction.

Adult↗
PubMed2004

Reproducibility of left ventricular volume and ejection fraction measurements in rat using pinhole gated SPECT.

PURPOSE: The aim of this study was to investigate the intra-individual reproducibility of left ventricular volume and ejection fraction measurements in living rat using pinhole gated single-photon emission computed tomography (SPECT). METHODS: Eight normal male Wistar rats underwent four pinhole gated SPECT acquisitions over a 1-month period. Two pinhole gated myocardial perfusion SPECT studies were acquired at a 1-week interval after injecting the animals with 439+/-52 MBq of (99m)Tc-sestamibi. Subsequently, 1 week after the perfusion studies, two pinhole gated blood pool SPECT studies were acquired at a 1-week interval after in vivo labelling of the red blood cells using 520+/-49 MBq of (99m)Tc-pertechnetate. Pinhole gated SPECT acquisitions were done on a single-head gamma camera equipped with a pinhole collimator with a 3-mm opening and 165-mm focal length. Parameters of acquisition were as follows: 44 mm radius of rotation, 360 degrees rotation using a circular orbit, 64 projections, 64x64 matrix, gating using 16 time frames and 22-min acquisition time. The projection data were reconstructed with a modified version of OSEM taking into account the pinhole geometry and incorporating a prior assumption about the temporal properties of gated SPECT studies to reduce noise. Left ventricular volumes and ejection fraction were measured using automatic quantification algorithms. Inter-study, inter-observer and intra-observer reproducibility was investigated. RESULTS: Pinhole gated myocardial perfusion and pinhole gated blood pool images were of high quality in all animals. No significant differences were observed between the repeated measurements. The pinhole gated myocardial perfusion SPECT studies indicated that differences between repeated measurements larger than 41 microl for end-diastolic volume, 17 microl for end-systolic volume and 3% for ejection fraction were significant. The pinhole gated blood pool SPECT studies indicated that differences between repeated measurements larger than 42 microl for end-diastolic volume, 38 mul for end-systolic volume and 5% for ejection fraction were significant. In addition to the reproducibility measures, the accuracy of volume measurements in pinhole gated blood pool SPECT was confirmed by a phantom study. Excellent correlations were observed between the measured volumes and the actual phantom volumes. CONCLUSION: Pinhole gated SPECT is an accurate and reproducible technique for cardiac studies of small animals. Because this technique is non-invasive, the same animal can be imaged repetitively, allowing follow-up studies.

Animals↗
PubMed1976

Measurement of right and left ventricular ejection fractions by radionuclide angiocardiography in coronary artery disease.

Utilizing a dynamic radionuclide method, the right and left ventricular ejection fractions were measured in 96 men with arteriographically defined coronary arterial disease and in 14 normal subjects. The radionuclidically estimated right ventricular ejection fraction (RVEF) correlated with the RVEF measured with biplane cineventriculographic studies (r = 0.80; n = 43), and the left ventricular ejection fraction (LVEF) measured from radionuclide data have been shown to correlate with the LVEF from single-plane cineventriculographic studies (r = 0.89; n = 60). The mean normal RVEF was 0.57 +/- 0.01 (SE) (range, 0.51 to 0.64), and the mean normal LVEF was 0.66 +/- 0.01 (range, 0.57 to 0.74). The LVEF was decreased in the men with coronary arterial disease and isolated obstruction of the left anterior descending coronary artery, double-vessel disease, and triple-vessel disease, but was normal in those with isolated right coronary disease. The RVEF was normal in each of these groups, except those with triple-vessel disease. Myocardial infarction was associated with impairment of LVEF, although some patients without myocardial infarction had depressed LVEF. The RVEF was preserved in patients with infarction, except those with multiple myocardial infarctions. Thus, impaired LVEF in coronary arterial disease is associated with myocardial infarction, and RVEF is relatively preserved except in multiple-vessel disease and myocardial infarction and in association with impaired LVEF.

Adult↗