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Updated: May 10, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Early two-dimensional echocardiographic measurement of left ventricular ejection fraction in acute myocardial
Insights
Left ventricular ejection fraction (LVEF) measured by echocardiography in acute myocardial infarction patients predicts clinical outcomes. Lower LVEF correlates with higher Killip class and mortality, identifying patients at risk for cardiogenic shock.
Area of Science:
- Cardiology
- Echocardiography
- Myocardial Infarction
Background:
- Acute transmural myocardial infarction (MI) significantly impacts left ventricular (LV) function.
- Assessing LV volume and ejection fraction is crucial for predicting patient prognosis.
- Traditional methods may be cumbersome for bedside assessment in acute settings.
Purpose of the Study:
- To evaluate the utility of 2D echocardiography in measuring LV volumes and ejection fraction in acute MI patients.
- To correlate echocardiographic findings with clinical outcomes, including Killip class, infarct size, and mortality.
- To determine if bedside LV function assessment can identify patients at high risk for complications like cardiogenic shock.
Main Methods:
- 90 patients admitted with acute transmural MI underwent 2D echocardiography using two orthogonal apical long axis views.
- Left ventricular (LV) volume and ejection fraction (LVEF) were calculated using a biplane area-length algorithm and modified Simpson's rule.
- Results were correlated with worst Killip class, peak creatine kinase-myocardial band (CK-MB) for infarct size, and mortality.
Main Results:
- Both echocardiographic algorithms showed significant trends towards increased LV end-diastolic and end-systolic volumes, and decreased LVEF with higher Killip class.
- Patients who died from cardiogenic shock had significantly lower LVEF (28.0-28.1%) compared to survivors (46.6-48.1%).
- LVEF was not significantly different in patients dying from other causes compared to survivors. Correlation with peak CK-MB was modest but significant.
Conclusions:
- Bedside measurement of LV ejection fraction using 2D echocardiography provides valuable clinical information in acute MI patients.
- Lower LVEF is associated with increased severity (Killip class) and higher mortality, particularly from cardiogenic shock.
- Echocardiographic assessment shortly after admission can identify patients likely to develop cardiogenic shock.
Abstract:
Left ventricular volume and ejection fraction were measured by 2-dimensional echocardiography from 2 orthogonal apical long axis views in 90 patients admitted with acute transmural myocardial infarction. Results were correlated with worst Killip class during hospital stay, enzymatic infarct size (peak CK-MB) and mortality. We used two algorithms, a biplane area-length algorithm and a modification of Simpson's rule. Both algorithms yielded essentially the same results: there were statistically significant trends towards higher end-diastolic and end-systolic volumes and lower ejection fraction with higher Killip -class. Ejection fraction was lower (P less than 0.01) in the 6 patients dying from cardiogenic shock (28.0 +/- 7.8% v. 46.6 +/- 10.1% in survivors with the area--length algorithm; 28.1 +/- 6.2% v. 48.1 +/- 10.2% with modified Simpson's rule). In 5 patients dying from other causes ejection fraction was 46.0 +/- 14.9% with the area-length method or 46.2 +/- 14.5% with Simpson's rule (not different from survivors). Correlation with peak CK-MB was only modest, though statistically significant: the regression equation was: y = -0. 39x + 54 (r = -0.35; P less than 0.01) with the area-length method; and y = -0. 41x + 55 (r = -0.37; P less than 0.01) with Simpson's rule. Left ventricular ejection fraction measured at the bedside in patients with acute myocardial infarction, can provide useful clinical information. Patients likely to develop shock can be identified shortly after admission.
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