Evaluation of clinical variables as predicators of left ventricular function in acute myocardial infarction

In 43 rural patients, all survivors of acute Myocardial infarction, left ventricular function was studied by 2-D echocardiography and evaluated in relation to 18 clinical predictors of left ventricular function. The mean left ventricular ejection fraction (LVEF) was 41.53 +/- 12.92% as compared to 70.02 +/- 7.02% in 506 healthy controls. LVEF was dichotomised at < 40% (n = 24) and > 40% (n = 19). Out of various clinical variables analysed following were found to be strong predictors of low LVEF. S3 gallop (p < 0.001) pulmonary rates (p < 0.001); Creatine phosphokinase > 200 I.U. (p < 0.001); Cardiomegaly on X-ray (p < 0.001); pulmonary congestion on chest X-ray (p < 0.001); and proportional pulse pressure (p < 0.001). There was a stepwise decline in the LVEF for each additional clinical variable. The over all predictive accuracy was 90%. It is concluded that readily obtainable clinical variables provide a useful bedside method of estimating LVEF after acute myocardial infarction.