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[Volumetric indices of the left ventricle in patients with ischemic heart disease]
Insights
This study found that nongeometric volume indices, including end-systolic volume index (ESVI), help assess left ventricular function in ischemic heart disease patients. Increased ESVI is linked to reduced ejection fraction and poorer outcomes, especially with myocardial infarct or aneurysm.
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Ischemic heart disease (IHD) poses significant challenges in assessing left ventricular (LV) function.
- Conventional radionuclide angiography provides some indices, but a comprehensive understanding of LV volume dynamics is crucial.
Purpose of the Study:
- To evaluate the utility of nongeometric volume indices for assessing LV function in patients with IHD.
- To correlate these volume indices with myocardial infarct status and complications.
Main Methods:
- Thirty patients with IHD were studied using radionuclide angiography at rest.
- Nongeometric methods were employed to determine LV volume indices, including end-systolic volume index (ESVI).
- Conventional ejection fraction (EF) and regional wall motion analysis were also performed.
Main Results:
- Patients without myocardial infarct showed decreased total LV ejection fraction (EF) and increased ESVI.
- Patients with myocardial infarct exhibited decreased total LV EF, increased ESVI, and more frequent regional wall motion abnormalities.
- Patients with postinfarction aneurysm had severely reduced EF, elevated end-systolic and diastolic volumes, and lower minute flow.
Conclusions:
- Nongeometric volume indices are valuable additions to conventional methods for assessing LV function in IHD.
- Increased ESVI is a key indicator of impaired LV function and is associated with myocardial infarct and aneurysm.
- These indices aid in evaluating hemodynamics and the impact of IHD complications.
Abstract:
In addition to the conventional indices of radionuclide angiography with ECG-gait in equilibrium, the authors determined the volume indices of the left ventricle at rest by the so-called nongeometric method in 30 patients with ischemic heart disease. Patients without myocardial infarct (13 subjects) had decreased total left-ventricular ejection fraction (EF), as a result of increase in the end systolic volume index (ESVI) in one of the tested patients. Changes in the regional fractions and in the wall kinetics were detected in 6, resp. in 8 patients. Patients with myocardial infarct--13 subjects--had decreased total left ventricular EF, as a result increased ESVI in 4 patients. Disturbances in the regional fraction and in the wall kinetics had 9 patients. Estimated for the whole group, the mean ESVI level was significantly higher than in the former group of patients. Patients with postinfarction aneurysm, in addition to the marked decrease of the total left ventricular EF, had increased and-systolic and diastolic volume index, which in some of the patients was associated with reduced stroke volume index. The minute flow levels were significantly lower than in the former two groups. Determination of the volume indices is an important supplement to the efforts to gain precise information on the functional state of the left ventricle and for evaluation of the hemodynamics and of the effect of complications which occur with the advancing of the ischemic heart disease.