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[Noninvasive studies of the left ventricular systolic function in patients over 65 years old]
P Schuster1, F J Seiwert, C Neuhaus
1II. Medizinische Klinik, St.-Marien-Krankenhauses Siegen.
Insights
Non-invasive ECG and pulse wave analysis can effectively assess left ventricular function in older adults with cardiovascular disease. The Weissler index (PEP/LVET) showed the strongest correlation with echocardiography ejection fraction.
Area of Science:
- Cardiology
- Biomedical Engineering
- Diagnostic Imaging
Context:
- Assessing left ventricular function is crucial for managing cardiovascular diseases in elderly patients.
- Echocardiography is the gold standard for measuring left ventricular ejection fraction but can be resource-intensive.
- Non-invasive methods offer a potential alternative for routine assessment.
Purpose:
- To evaluate the correlation between non-invasive left ventricular time intervals and echocardiographic ejection fraction in elderly patients with cardiovascular disease.
- To determine the diagnostic accuracy of ECG, apex cardiograms, carotid-pulse curves, and phonocardiograms for assessing cardiac function.
- To identify the most reliable non-invasive parameters for quantifying left ventricular function.
Summary:
- Left ventricular functions were assessed in 96 elderly patients (mean age 74.6 years) with cardiovascular diseases using non-invasive methods (ECG, apex cardiograms, carotid-pulse curves, phonocardiograms) and compared with echocardiography.
- The Weissler index (pre-ejection period/left ventricular ejection time ratio, PEP/LVET) demonstrated the strongest correlation (r = -0.76, P < 0.001) with ejection fraction.
- Other significant correlations were found with pre-ejection period (PEP) (r = -0.65, P < 0.001) and rate-corrected PEP (r = -0.71, P < 0.001).
- Plain chest X-rays were insufficient for quantitative assessment of diminished cardiac pump function.
Impact:
- Non-invasive methods, particularly the Weissler index, show promise for reliably assessing left ventricular function in elderly cardiovascular patients.
- These findings could lead to more accessible and cost-effective cardiac function monitoring.
- Chest X-rays are not recommended for quantitative assessment of cardiac pump function in this population.
Abstract:
Left ventricular functions were assessed in 96 patients (26 men, 70 women aged over 65 years; mean age 74.6 +/- 6.3 years) with various cardiovascular diseases (arterial hypertension, coronary heart disease, cardiomyopathy, various cardiac defects) by comparing various left-ventricular time intervals obtained from resting ECGs, apex cardiograms, carotid-pulse curves and phonocardiograms with left-ventricular ejection fractions by echocardiography. The correlations were strongest with the Weissler index (ratio of pre-ejection and left-ventricular ejection times), PEP/LVET (r = -0.76; P less than 0.001), with PEP itself (r = -0.65; P less than 0.001), as well as with rate-corrected PEP (r = -0.71; P less than 0.001). The plain chest X-ray did not make it possible to assess quantitatively patients with diminished cardiac pump function, despite radiological signs of congestion.