Radionuclide assessment of regional left ventricular function in acute myocardial infarction

To determine changes in global and regional left ventricular function following acute myocardial function, 17 patients underwent radionuclide angiography at 3 and 10 days post infarction. Five patients had nontransmural myocardial infarction and 12 had transmural infarction (six anterior and six inferior). There were no previous infarctions in 16 (94%) patients. Regional ejection fractions were calculated by dividing the left ventricle into four quadrants using the geometric center of the left ventricle on the end-diastolic frame as a reference point. At 3 days post infarction, 8 of 17 (47%) patients had an abnormality of global left ventricular ejection fraction (LVEF), whereas 16 of 17 (94%) patients had abnormalities of one or more regional ejection fractions (p less than 0.01). Between 3 and 10 days, global LVEF did not change (51% to 49%, p = NS). However, there were significant changes in 23 of 68 (34%) regional LVEFs. These changes did not relate to type, ECG location, creatine kinase (CK) size of infarction, or initial global LVEF. These data suggest that regional LVEF is a sensitive technique for identifying segmental dysfunction associated with myocardial infarction. In addition, significant changes occur in regional LV function during acute myocardial infarction despite stable serial global LV performance.