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Prospective, randomised, double-blind study of radionuclide determination of left-ventricular ejection fraction in
Insights
Knowledge of left-ventricular ejection fraction (LVEF) did not reduce heart failure after myocardial infarction. This study highlights the need for rigorous trials to evaluate diagnostic methods in clinical practice.
Area of Science:
- Cardiology
- Clinical Research
Background:
- Acute myocardial infarction can lead to left-ventricular heart failure.
- Left-ventricular ejection fraction (LVEF) is a key indicator of cardiac function.
Purpose of the Study:
- To investigate if knowledge of LVEF influences the incidence of left-sided heart failure post-myocardial infarction.
- To assess the impact of LVEF information on clinical management and patient outcomes.
Main Methods:
- A controlled, randomized, double-blind study involving 60 patients post-myocardial infarction.
- Patients were divided into two groups: one where cardiologists knew the LVEF, and one where they did not.
- LVEF was determined prior to hospital discharge.
Main Results:
- No significant difference in LVEF between groups at one month post-discharge.
- No significant differences in clinical or radiological signs of heart failure, or drug usage, at two months.
- Cardiologists' clinical LVEF estimates correlated significantly with radionuclide determinations.
Conclusions:
- Knowledge of LVEF did not alter the clinical outcome in patients recovering from myocardial infarction.
- Emphasizes the necessity of randomized controlled trials for evaluating diagnostic methods.
Abstract:
In a controlled, randomised, double-blind study to see whether knowledge of left-ventricular ejection fraction (LVEF) could reduce the frequency of left-sided heart failure after acute myocardial infarction, LVEF was determined a few days before hospital discharge in a consecutive series of 60 patients. Subsequently, the patients were randomly assigned to two groups. The cardiologist responsible for their treatment was aware of the LVEF result in group I but not in group II. A month after hospital discharge there was no significant difference in the LVEF between the groups. 2 months after discharge there were no significant differences between the groups in clinical and radiological signs of left-ventricular heart failure or the use of drugs. The cardiologist's clinical estimate of the LVEF and the result of the radionuclide determination were significantly correlated. Thus, the use of LVEF did not change the clinical outcome. The need for randomised controlled studies in the evaluation of diagnostic methods is emphasised.