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PubMed1993

Comparison of left ventricular function by echocardiographic automated border detection and by radionuclide ejection fraction.

Echocardiographic automated border detection can provide on-line estimates of left ventricular cavity area by differentiating blood from tissue backscatter characteristics. The objective of this study was to assess the ability of short-axis measurements of left ventricular cavity area by automated border detection to determine left ventricular function by comparing these measurements to radionuclide measures of ejection fraction in the same patients. Eighty-eight consecutive patients, aged 53 +/- 14 years, underwent automated border detection studies within 2 hours of radionuclide ventriculography. Short-axis imaging with automated border detection was attempted at basal, midpapillary muscle, and apical levels. Maximal left ventricular length was also measured from apical 4- and 2-chamber views by standard imaging. Fractional area change--(end-diastolic area-end-systolic area)/end-diastolic area--was determined at each short-axis level. Volumes and ejection fractions were calculated using: volume = 5/6 (midventricular area).length. Simpson's rule for 3 short-axis measurements was calculated using: volume = (length/12) (5.basal area + 2.mid-area + 4.apical area). Technically adequate automated border detection data could be obtained on 69 patients (78%) at basal and mid-levels, and at all 3 short-axis levels in 66 patients (75%). Correlations with radionuclide ejection fraction were as follows: midventricular fractional area change--R = 0.84, SEE = 12%, y = 0.86 x - 7; area-length ejection fraction--R = 0.89, SEE = 9%, y = 0.96 x - 4; and Simpson's rule--R = 0.91, SEE = 8%, y = 0.89 x + 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Implantable defibrillator event rates in patients with idiopathic dilated cardiomyopathy, nonsustained ventricular tachycardia on Holter and a left ventricular ejection fraction below 30%.

OBJECTIVES: This study investigated the incidence of appropriate implantable cardioverter defibrillator (ICD) interventions for ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients with idiopathic dilated cardiomyopathy (IDC) and nonsustained VT in the presence of a left ventricular ejection fraction below 30%, versus in patients with syncope and patients with a history of VT or VF. BACKGROUND: To date, only limited information is available about the prophylactic use of ICDs in patients with IDC. METHODS: From January 1993 to July 2000, 101 patients with IDC underwent implantation of ICDs with electrogram storage capability at our institution. Patients were placed into one of three groups according to their clinical presentation: asymptomatic or mildly symptomatic nonsustained VT in the presence of a left ventricular ejection fraction < or = 30% (49 patients, prophylactic group), unexplained syncope or near syncope (26 patients, syncope group) and a history of sustained VT or VF (26 patients, VT/VF group). RESULTS: During 36 +/- 22 months follow-up, 18 of 49 patients (37%) in the prophylactic group received appropriate shocks for VT or VF, compared with 8 of 26 patients (31%) in the syncope group and with 9 of 26 patients (35%) of the VT/VF group. Multivariate Cox analysis of baseline clinical variables identified left ventricular ejection fraction, atrial fibrillation and a history of sustained VT or VF as predictors for appropriate ICD interventions during follow-up. CONCLUSIONS: Patients with IDC and prophylactic ICD implantation for nonsustained VT in the presence of a left ventricular ejection fraction < or = 30% had an incidence of appropriate ICD interventions similar to that of patients with a history of syncope or sustained VT or VF. These findings indicate that ICDs may have a role in not only secondary but also primary prevention of sudden death in IDC.

Adolescent↗
PubMed1993

The measurement of right ventricular ejection fraction by thermodilution. A comparison of values obtained using differing injectate ports.

Thermodilution measurements of cardiac output and right ventricular ejection fraction were obtained using a rapid response pulmonary artery catheter. Values were compared when injectate was administered via either a cannula within the right internal jugular vein or the dedicated right atrial port of the pulmonary artery catheter. Mean (SD) bias for cardiac output and right ventricular ejection fraction measurements were 0.08 (0.32) l.min-1 and 2.6 (6.6)% respectively. We therefore conclude that both injectate techniques will provide similar values for cardiac output but dissimilar values for right ventricular ejection fraction measurement.

Cardiac Output↗
PubMed1997

Comparison of echocardiographic acoustic quantification system and radionuclide ventriculography for estimating left ventricular ejection fraction: validation in patients without regional wall motion abnormalities.

Echocardiographic automated border detection of blood-endocardium interface is made on the basis of the principle of acoustic quantification. The automated border system is capable of providing on-line left ventricular (LV) cavity area and function. Recently, ABD algorithms have been devised to estimate LV volume on line from a long-axis image, calculated by established area-length method or Simpson's formula. To test the clinical validity of this newly developed echocardiographic method, LV volumes and ejection fraction measured by real-time acoustic quantification were compared with radionuclide ejection fraction in 24 subjects on the same day. Patients were included in the study if > or = 75% of their endocardium was visualized with conventional two-dimensional echocardiography. Sixteen (66%) of 24 patients had a technically adequate conventional echocardiogram with a broad range of ventricular dimensions and systolic function. None of the study patients had regional wall motion abnormalities. Echocardiographic measurements were obtained from the LV apical four-chamber, long-axis view. Ejection fraction, determined by the acoustic quantification and by radionuclide ventriculography, showed a strong linear relation (r = 0.92, standard error of the estimate = 4.4, p < 0.05). However, acoustic quantification overestimated the radionuclide ejection fraction with rather wide limits of agreement (3.8% +/- 16.4%; bias +/- 2 SD). Thus echocardiographic automated border detection technique is a reasonably accurate method for on-line assessment of LV function.

Adult↗
PubMed1984

Right ventricular ejection fraction response to exercise in patients with coronary artery disease: influence of both right coronary artery disease and exercise-induced changes in right ventricular afterload.

To determine the influence of proximal right coronary artery disease and right ventricular afterload on right ventricular ejection fraction response to exercise, 64 patients were studied at rest and after supine exercise with gated equilibrium radionuclide angiography and coronary angiography. Right ventricular afterload response to exercise was estimated from determinations of exercise-induced changes in pulmonary blood volume, previously shown to correlate with exercise-induced changes in pulmonary capillary wedge pressure. Values for right ventricular ejection fraction decreased from rest to exercise (48 +/- 5% to 42 +/- 9%, p less than 0.001) in patients with an elevated pulmonary blood volume ratio. Values were unchanged in patients with isolated proximal right coronary artery disease (rest 49 +/- 3%, exercise 47 +/- 7%), decreased in patients with combined right and left coronary disease (rest 48 +/- 6%, exercise 39 +/- 10%, p less than 0.001) and increased (rest 47 +/- 5%, exercise 52 +/- 6%, p less than 0.001) in patients with isolated left coronary artery disease. To determine the coinfluence of coronary anatomy and changes in pulmonary blood volume, patients were classified by pulmonary blood volume ratio. Among patients with a normal pulmonary blood volume ratio, right ventricular ejection fraction did not change significantly in those with proximal right coronary artery disease during exercise, but increased significantly in patients with isolated left coronary disease. Among patients with an elevated pulmonary blood volume ratio, right ventricular ejection fraction during exercise increased significantly in those with proximal right coronary artery disease but was unchanged in patients with isolated left coronary disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Coronary bypass with ejection fraction of 0.20 or less using centigrade cardioplegia: long-term follow-up.

Forty-two patients with an ejection fraction of 0.20 or less underwent coronary artery bypass grafting from 1986 to 1990 using a method of myocardial protection we term "centigrade cardioplegia," combining single-dose, cold, crystalloid cardioplegia, systemic hypothermia, and local hypothermia. Thirty-day mortality was 4.8% (2/42). Perioperative morbidity included two myocardial infarctions (4.8%) and one stroke (2.4%), which fully resolved. Postoperative left ventricular function improved (left ventricular ejection fraction, 0.157 +/- 0.028 to 0.226 +/- 0.085; p < 0.0002), as did New York Heart Association class (3.4 +/- 0.73 to 1.8 +/- 0.63; p < 0.0001) and Canadian class (3.3 +/- 0.81 to 0.61 +/- 0.92). Survival, 88% at 1 year, declined to 68% at 3 years and 34% at 6 years. This high-risk group had very acceptable short-term results, indicating adequate intraoperative myocardial protection. Four clinical variables were associated with long-term survival: (1) chief complaint of pain only (p = 0.05), (2) history of unstable angina (p = 0.04), (3) Canadian class less than IV (p = 0.05), and (4) New York Heart Association class less than IV (p = 0.05). Reduced survival, although not statistically significant (p = 0.07), was noted for right ventricular ejection fraction of 0.30 or less. These factors may help predict which patients with severe left ventricular dysfunction will benefit from revascularization.

Angina Pectoris↗
PubMed2000

Reproducibility and accuracy of gated SPECT for determination of left ventricular volumes and ejection fraction: experimental validation using MRI.

UNLABELLED: Quantitative gated SPECT (QGS) has been used for computation of left ventricular volumes and ejection fraction. This study evaluated, first, the effect of injected dose, time of imaging, and background activity on the reproducibility of QGS and, second, the accuracy of QGS, compared with cine MRI, for determining left ventricular volumes and ejection fractions in dogs with and without perfusion defects. METHODS: Sixteen dogs were subjected to either chronic occlusion of the circumflex artery (group I, no perfusion defect) or acute occlusion of the anterior descending coronary artery (group II, perfusion defect). Both groups underwent serial MRI and SPECT. RESULTS: ( QGS was very reproducible using the automated program (r = 0.99997). Correlation between left ventricular ejection fraction (LVEF) at 15 and 45 min was poor after the low-dose injection (r = 0.54; SE = 9%) and only fair after the high-dose injection (r = 0.77; SE = 5%). Correlation was poor in the presence of significant background activity (r = 0.36; SE = 12%). Correlation between QGS left ventricular volumes and MRI was good for group I (end-diastolic volume, r = 0.86; end-systolic volume, r = 0.81) and only fair for group II (end-diastolic volume, r = 0.66; end-systolic volume, r = 0.69). The overall LVEF correlation between QGS and MRI was poor (r = 0.51). QGS LVEF (mean +/- SD, 42% +/- 3%) overestimated MRI LVEF (29% +/- 2%). CONCLUSION: QGS provides a highly reproducible estimate of LVEF. However, QGS is affected by changes in background activity, time of imaging, and injected dose. In the presence of perfusion defects, QGS overestimated volume relative to MRI. The correlation between QGS- and MRI-derived LVEF was poor in this canine model.

Animals↗
PubMed1986

Prognostic significance of right ventricular ejection fraction for persistent complex ventricular arrhythmias and/or sudden cardiac death after first myocardial infarction: relation to infarct location, size and left ventricular function.

To assess the prognostic significance of right ventricular dysfunction after a first myocardial infarction for complex ventricular arrhythmias and or sudden cardiac death in relation to infarct location, size and left ventricular function, a series of 127 consecutive patients was prospectively studied and followed up for one year. Prior to hospital discharge, a 24-hour electrocardiographic recording and radionuclide angiocardiography were performed. Right ventricular ejection fraction was related to inferior infarct location and size (r = 0.45, P less than 0.01): similarly left ventricular ejection fraction was related to anterior infarct location and size (r = 0.76, P less than 0.001). The incidence of severe ventricular arrhythmias was significantly higher in patients with isolated right or left ventricular dysfunction compared to patients with normal function; it was highest in patients with severe depression of both ventricles. Patients with complex ventricular arrhythmia and/or sudden cardiac death had significantly reduced left and right ventricular ejection fractions. Detailed analysis in patients with left ventricular ejection fraction greater than 0.40 vs. less than or equal to 0.40 showed that presence of complex ventricular ectopic activity and/or sudden cardiac death after myocardial infarction was related not only to left, but also independently to right ventricular dysfunction. These results imply a significant prognostic contribution of right ventricular dysfunction to the occurrence of severe ventricular arrhythmias and/or sudden cardiac death after myocardial infarction independent of and additive to left ventricular dysfunction.

Adult↗
PubMed1988

[Videodensitometric analysis of venous digital angiography of the left ventricle: application to the measurement of the ventricular ejection fraction and volumes].

Intravenous digital angiography of the left ventricle (LV) was submitted to videodensitometric analysis in order to measure the ejection fraction (EF) and ventricular volumes. The video-densitometric method was first validated using an experimental model consisting of latex balloons filled with contrast medium. The correlation for ejection fraction measurements was satisfactory (r = 0.9449), with less than 10% errors. For ventricular volumes, the correlation was also good (r = 0.97 and 0.92 with the Chapman and Dodge methods respectively), but marked variations across individuals were found. Digital videodensitometry thus appears to be a feasible and reliable method for ejection fraction and ventricular volume measurements. Further studies are needed to determine the accuracy of measurements of ventricular volumes.

Densitometry↗
PubMed2006

Freehand three-dimensional assessment of left ventricular volumes and ejection fraction with ultrasound contrast agent LK565.

AIMS: Accurate assessment of left ventricular function by determining left ventricular volumes and ejection fraction is important in evaluating the prognoses of patients with heart failure. Two-dimensional (2D) echocardiography suffers from low correlation with reference methods like ventriculography. Three-dimensionally (3D) assessed data have been proved to have better conformity. Endocardial border delineation remains a problem, however, especially in patients with suboptimal recordings. Few data exist on 3D-echocardiographic volumetry with ultrasound contrast agents (UCAs). We evaluated the second-generation UCA LK565 for its boundary-tracing capacities in freehand 3D echocardiography in a phase II clinical trial. Safety and efficacy of the novel contrast agent were also evaluated. METHODS AND RESULTS: Forty patients between the age of 42 and 77 were included in this trial. Left ventricular end-systolic and -diastolic volume (LVESV, LVEDV) and ejection fraction (EF) were determined by either 2D or 3D freehand second harmonic echocardiography with and without use of LK565. Parameters were compared statistically with ventriculography performed in 35 patients. Immune response to LK565 was evaluated by analysing phagocytosis capacity and kinetics of inflammatory cytokines (TNF-alpha, IL-4, IL-10, IFN-gamma). Patients were monitored for adverse events up to 72 h after application of the UCA. Calculated values for left ventricular volumes and ejection fraction correlated best for freehand 3D echocardiography in combination with LK565 (r=0.92 for LVEDV; r=0.96 for LVESV; r=0.94 for EF). Excellent left ventricular contrast enhancement was achieved for approximately 8 min. A reversible saturation of phagocytosis capacity for monocytes and neutrophils set in with a maximum peak at 6h. No significant increase in cytokine expression was observed. CONCLUSION: LK565 improves feasibility of endocardial border delineation in 3D echocardiography, leading to better correlation of left ventricular volumetry with reference methods. Efficacy and safety of LK565 are equivalent to those of conventional UCAs.

Adult↗
PubMed2006

MDCT of right ventricular function: comparison of right ventricular ejection fraction estimation and equilibrium radionuclide ventriculography, part 1.

OBJECTIVE: The aim of this study was to calculate right ventricular ejection fraction by use of ECG-gated MDCT and to compare the results with those of equilibrium radionuclide ventriculography. SUBJECTS AND METHODS: Forty-nine consecutively examined patients (30 men, 19 women; mean age, 59 years) with known or suspected right ventricular dysfunction secondary to bronchopulmonary (n = 30) or pulmonary vascular (n = 19) disease underwent ECG-gated 16-MDCT angiography of the heart (rotation time, 0.42 second; 120 kV; 300 mAs; collimation, 12 x 0.75 mm; pitch, 0.2) after CT angiographic examination of the entire thorax according to a standard protocol. Biphasic administration of a 30% contrast agent was systematically performed (phase 1, 90 mL at 3 mL/s; phase 2, 30 mL at 1.5 mL/s); no patient received additional medication. Right ventricular ejection fraction was calculated after two reviewers in consensus determined the reconstruction windows and segmentation of the right ventricular cavity on a series of diastolic and systolic short-axis images. The results were compared with those of equilibrium radionuclide ventriculography. RESULTS: At data acquisition, the mean (+/- SD) heart rate of the study group was 82 +/- 13.87 beats per minute (BPM) (range, 51-115 BPM). ECG showed a sinus rhythm in 30 (61%) of the patients and irregular cardiac rhythm in 19 (39%) of the patients. Agreement between the two techniques was estimated by intraclass correlation coefficient (0.77), the method of Bland and Altman (limits of concordance, -14.9 and 13.7), and percentage of variability between two measurements expressed by mean absolute percentage error (12.1%). The estimated effective dose for heart examination was 7.48 mSv with CT and 5 mSv with scintigraphy. The mean effective dose for the chest and heart CT examinations was 11.64 mSv. CONCLUSION: Right ventricular ejection fraction can be reliably estimated with 16-MDCT in unselected patients.

Adult↗
PubMed1988

Two-dimensional echocardiographic evaluation of right ventricular ejection fraction: comparison between three different methods.

Twelve patients with chronic cor pulmonale due to chronic obstructive pulmonary disease have been examined with 2D echocardiography, performing four-chamber view by apical and subcostal approaches, and the right ventricular outflow tract view by the subcostal approach. These views have permitted evaluation of right ventricular volumes, and hence right ventricular ejection fraction, by the use of three different geometrical formulae: the biplane area-length method, Simpson's rule and the pyramidal method. The ejection fraction values obtained from each method have been compared to those obtained by equilibrium radionuclide angiocardiography. Four-chamber apical and subcostal views were satisfactorily recorded in 10 of the 12 patients (83.3%), and right ventricular outflow tract view in 8 patients (66.6%). No significant statistical differences have been found between measurements obtained from the three different echocardiographic examinations performed on each subject by the same operator, so demonstrating a satisfactory reproducibility of the technique. The highest correlation coefficient for ejection fraction was shown by Simpson's rule (r = 0.96, p less than 0.001), with a very narrow confidence intervals, while the r values for the biplane area-length method was 0.63 (p less than 0.05) and for the pyramidal method 0.50 (not statistically significant), with increasingly wider confidence intervals. The statistically significant difference between the three correlation coefficients demonstrates the higher accuracy of Simpson's rule for the determination of right ventricular ejection fraction.

Aged↗
PubMed1993

Abnormal gallbladder nuclear ejection fraction predicts success of cholecystectomy in patients with biliary dyskinesia.

The management of patients with symptoms consistent with biliary tract disease who do not have gallstones is difficult. We retrospectively reviewed the charts of 18 patients who underwent cholecystokinin cholescintigraphy at our institution to determine if this procedure was reliable in identifying patients who would benefit from cholecystectomy. All patients underwent biliary screening, and a gallbladder ejection fraction of less than or equal to 35% was considered abnormal. None of the patients had evidence of gallstones by ultrasound. There were 11 patients with abnormal ejection fractions. All 11 patients (100%) had "classic" biliary colic and underwent cholecystectomy. The pathologic diagnosis was chronic cholecystitis in every patient. All patients had complete relief of their symptoms postoperatively with a mean follow-up of 10 months. There were six patients with normal ejection fractions. Only one patient in this group had "classic" biliary colic. This patient had a gallbladder ejection fraction of 38% and endoscopic evidence of gastritis. This patient remains symptomatic despite H2 blockade. The remaining five patients had nonspecific right upper quadrant or epigastric pain. These patients had endoscopic evidence of gastritis, and symptoms were relieved with H2 blockade. The remaining patient had an indeterminate scan due to radioactivity in the duodenum overlying the gallbladder and was excluded from this analysis. Cholecystokinin cholescintigraphy is a useful test in identifying those patients with biliary dyskinesia or acalculous cholecystitis who will benefit from cholecystectomy.

Biliary Dyskinesia↗
PubMedDate not supplied

[Value of global ejection fractions based on the presence or absence of left ventricular dyskinesia. A comparison between contrast angiography and angioscintigraphy].

The total ejection fraction of the left ventricle is studied in 37 patients, most of them with coronary disease, according to two methods: contrast angiography in a single plane and angioscintigraphy (first passage and balanced), in order to compare the results according to the presence or the absence of dyskinesias. The two methods are performed in succession according to the usual views. The population is divided in two sub-groups according to the presence (17 patients) or the absence (20 patients) of segmental abnormalities. Segmental abnormalities are divided into 11 antero-apical aneurysms and 6 infero-posterior aneurysms. The correlations of the ejection fractions calculated according to the two methods and the two views, are usually satisfactory in the two sub-groups and especially as the parietal kinetics is homogeneous. In case of segmental abnormalities of the contraction, there are variations in the total ejection fractions depending on the technique and the views that are used, but the differences are not significant.

Arrhythmias, Cardiac↗
PubMed1987

A new noninvasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction: based on signal-averaged electrocardiogram, radionuclide ejection fraction and Holter monitoring.

A prospective study of the prognostic significance of the signal-averaged electrocardiogram (ECG), left ventricular function and 24 hour Holter ECG monitoring was performed in 102 patients (age 63 +/- 11 years) after myocardial infarction. The signal-averaged ECG (40 Hz high pass bidirectional filtering) was obtained 10 +/- 6 days after the acute myocardial infarction and all three tests were performed within 72 hours of each other. Ejection fraction was determined by radionuclide ventriculography. An abnormal signal-averaged ECG was seen in 44% of patients; abnormal ejection fraction (less than 40%) in 52% and high grade ectopic activity (greater than or equal to 10 ventricular premature depolarizations/h or couplets, or nonsustained ventricular tachycardia, or a combination of these) in 62%. During a 12 +/- 6 month follow-up period, 15 patients (14.7%) had an arrhythmic event defined as sustained ventricular tachycardia or sudden cardiac death, or both. The event rates were higher in patients with an abnormal versus a normal signal-averaged ECG (29 versus 3.5%, p = 0.003), an abnormal versus a normal ejection fraction (24 versus 6%, p = 0.001) and the presence versus the absence of high grade ectopic activity (23 versus 9%, p = 0.09). Patients with an abnormal signal-averaged ECG and an abnormal ejection fraction had a significantly higher (p = 0.0007) event rate than did patients in whom both the tests were normal (36 versus 0%; odds ratio 30.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Importance of hemodynamic response to therapy in predicting survival with ejection fraction less than or equal to 20% secondary to ischemic or nonischemic dilated cardiomyopathy.

To identify patients with left ventricular ejection fractions less than 20% who are likely to survive on tailored medical therapy after referral to transplantation, this study of 152 patients addressed the hypotheses that (1) severely elevated filling pressures initially measured at referral would not necessarily predict poor outcome, (2) survival would be best when low pulmonary wedge pressures could be achieved with therapy tailored for hemodynamic goals, and (3) coronary artery disease would be an independent risk factor for early mortality. Despite an average initial ejection fraction of 0.15, cardiac index of 2.0 liters/min/m2 and pulmonary artery wedge pressure of 28 mm Hg, the actuarial survival with tailored therapy was 63% at 1 year, with 34 of 41 (83%) deaths occurring suddenly. Survival was not related to initial filling pressure elevation, but was best predicted by the pulmonary artery wedge pressures during therapy; patients achieving pressure of less than or equal to 16 mm Hg had 1-year survival of 83 vs 38% (p = 0.0001). The other independent predictors were serum sodium and coronary artery disease. Patients with high filling pressures during therapy and coronary artery disease had 21% survival at 1 year. Survival after referral to transplantation with an ejection fraction less than or equal to 20% is better than previously described. Patients in whom left ventricular filling pressures cannot be adequately reduced by tailored therapy, particularly if coronary artery disease is present, should be considered for early transplantation.

Adult↗
PubMed1988

Effects of coronary thrombolysis on left ventricular ejection fraction in patients with acute myocardial infarction.

Left ventriculograms were performed on 65 patients with acute myocardial infarction, once upon admission and again 3 months later. In 29 cases urokinase was injected intravenously and/or intracoronarily. The other 17 were treated without urokinase. In 8 out of 29 patients whose infarct-related coronary arteries remained completely occluded following urokinase therapy, the global ejection fraction was reduced from 54 +/- 3% during the acute stage to 46 +/- 5% during the chronic stage (p less than 0.001). However, for the 21 patients whose coronary arteries were successfully recanalized, the 2 values were the same (52 +/- 2%). The highest global ejection fractions were seen in 19 spontaneously recanalized patients (acute: 54 +/- 2%, chronic: 55 +/- 2%). For the 8 unsuccessful patients, the regional ejection fraction for the infarcted portion was reduced from 20 +/- 5% during the acute stage to 18 +/- 6% during the chronic stage. But for the successful patients there was an improvement from 22 +/- 2% during the acute stage to 27 +/- 2% during the chronic stage. Again, the regional ejection fraction was the highest for the spontaneously recanalized group, being 31 +/- 2% and 36 +/- 3% during the acute and chronic stages, respectively. These results indicate that if the coronary artery remains occluded during the acute stage the reduced left ventricular function continues to deteriorate even more during the chronic stage. Successful coronary thrombolysis, however, might salvage the infarcted myocardium as well as preserve the function of the left ventricle.

Chronic Disease↗
PubMed2001

Interval-dependent potentiation of left ventricular contractility is preserved in patients with atrial fibrillation and depressed ejection fraction.

Echocardiographic techniques were used to measure left ventricular isovolumic and ejection phase indexes of contractility in 54 patients with atrial fibrillation, and the relations between cycle lengths and contractility were compared in patients with normal and depressed ejection fractions. Data indicate that variations in contractility occur in a pattern that is consistent with postextrasystolic potentiation and that such interval-dependent potentiation is preserved in patients with atrial fibrillation and depressed ejection fraction.

Aged↗