Circulation, Vol 65, 1094-1099, Copyright © 1982 by American Heart Association
AJ Kemper, JA Bianco, RM Shulman, ED Folland, AF Parisi and DE Tow
To evaluate the clinical usefulness of the first-third ejection fraction
(1/3 EF) for detecting patients with coronary artery disease (CAD), resting
contrast ventriculography and first-pass radionuclide angiography with a
high-count-rate, multicrystal camera system were performed in 47 subjects:
22 normal controls (group 1) and 25 patients with clinically stable angina
pectoris and severe CAD (mean 2.3 vessels) without (group 2, n = 12) and
with (group 3, n = 13) resting wall motion abnormalities. By contrast
angiography, only group 3 had depressed global EF or 1/3 EF compared with
control (global EF: group 1,0.71 +/- 0.09; group 2, 0.67 +/- 0.09 [NS];
group 3,049 +/- 0.05 [p less than 0.01 vs groups 1 and 2]; 1/3 EF: group
1,0.29% +/- 0.06;' group 2, 0.28 +/- 0.05 [NS]; group 3,0.22 +/- 0.05 [p
less than 0.02 vs groups 1 and 2]). Whereas 11 of 25 CAD patients had
global EF outside the normal range, only two of 25 had depressed 1/3 EF.
Both had left ventricular asynergy and a depressed global EF. Studies
performed using first-pass radionuclide angiography revealed similar
results i.e., only four of 25 CAD patients, all with left ventricular
asynergy and depressed global EF, had depressed 1/3 EF values. A wide range
of 1/3 EF values was found in normal subjects by both techniques. Thus, the
ejection fraction during the first third of systole at rest is of limited
value for detecting patients with CAD.
ARTICLES
The interval ejection fraction: a cineangiographic and radionuclide study
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