The Assessment of Left Ventricular Ejection Fraction in Patients with Ischaemic Heart Disease by Contrast Ventriculography and Nuclear Angiography

1977 ◽  
Vol 53 (1) ◽  
pp. 55-61 ◽  
Author(s):  
A. L. Muir ◽  
W. J. Hannan ◽  
H. M. Brash ◽  
V. Baldwa ◽  
H. C. Miller ◽  
...  

1. In 18 patients with ischaemic heart disease left ventricular ejection fraction, measured by two different nuclear angiographic methods, has been compared with ejection fraction measured by single-plane contrast angiography. 2. The first nuclear angiographic technique involves detection of variation in the radioactivity from the left ventricle during the initial passage of a bolus of 99Tcm-labelled human serum albumin injected intravenously; the second is our own modification of a ‘gated’ method, which accumulates the radioactivity detected during the continuing recirculation of the plasma bound radioisotope, so presenting an ‘averaged’ ventricular volume curve. 3. Ejection fraction, measured by the ‘bolus’ method, is lower than that measured either by contrast ventriculography or by the ‘gated’ method. This may be due to a damping effect. 4. Ejection fraction measured by the ‘gated’ method is well correlated with that measured by contrast ventriculography (r = 0·89). 5. Our modification of the ‘gated’ method, which presents the changes in ventricular volume throughout the cardiac cycle, without needing computer facilities, is a useful non-invasive means for assessment of left ventricular function.

2017 ◽  
Vol 27 (3) ◽  
pp. 26652
Author(s):  
Isabella Martins de Albuquerque ◽  
Andrieli Barbieri Garlet ◽  
Dannuey Machado Cardoso ◽  
Tamires Daros Santos ◽  
Sérgio Nunes Pereira

***Relationship between functional class and left ventricular ejection fraction in patients with coronary heart disease who were candidates for cardiac rehabilitation***AIMS: To assess the potential relation between the New York Heart Association functional class and left ventricular ejection fraction in coronary heart disease patients who were candidates for cardiac rehabilitation.METHODS: This is a retrospective cross-sectional study based on the analysis of medical records of coronary heart disease patients who were candidates for the Cardiac Rehabilitation Program of Hospital Universitário de Santa Maria, state of Rio Grande do Sul, Brazil. Both male and female patients aged 50 to 65 were included, whereas patients with chronic renal failure, anemia, poor echocardiographic image quality, non-sinus rhythm, and also those individuals whose medical records lacked sufficient information were excluded. Data were collected from August 2015 to March 2016, and the information that made up the variables of interest was extracted from the medical records, such as: clinical and demographic data (sex, age, comorbidities, clinical diagnosis, surgical and drug treatment), left ventricular ejection fraction values obtained by echocardiography (conventional and tissue Doppler echocardiography), and functional class from the ergometric test. Statistical analysis was performed using Kruskal-Wallis test followed by Dunn’s post-hoc test.  The significance level was set at p<0.05.RESULTS: A total of 131 medical records were consecutively evaluated, of which 102 met the inclusion criteria. Mean age was 59.23±7.95 years and 70 (68.63%) patients were male, with a predominance of functional class I. There was an inverse relation between functional class and ejection fraction: the more advanced the functional class, the more compromised the cardiac performance (p=0.036).CONCLUSIONS: In this sample of patients with coronary heart disease who were candidates for cardiac rehabilitation, there was an inverse relation between left ventricular ejection fraction and functional class. This finding provides information about the limitations imposed by the disease on patient’s exercise capacity and heart function and can contribute to the development of a physical training program.


Medicina ◽  
2018 ◽  
Vol 54 (3) ◽  
pp. 34 ◽  
Author(s):  
Stefan Naydenov ◽  
Nikolay Runev ◽  
Emil Manov ◽  
Daniela Vasileva ◽  
Yavor Rangelov ◽  
...  

Background and objectives: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a major risk factor for cardiovascular complications. Our study aimed to investigate the prevalence, risk factors, demographics, co-morbidities and treatment of AF among in-hospital Bulgarian patients. Materials and Methods: A cross-sectional study including 1027 consecutive patients (n = 516, 50.2% males) with a mean age of 67.6 ± 11.3 years, hospitalized for any reason from 1 May until 31 December 2016 in one of the largest internal clinics in Bulgaria, was carried out. Results: Atrial fibrillation was diagnosed in 634 (61.7%) patients. The prevalence of modifiable AF risk factors was as follows: heart failure, 98.9%; arterial hypertension (HTN), 93.5%; valvular heart disease, 40.9%; chronic lung disease, 26.7%; type 2 diabetes mellitus, 24.9%; thyroid disease, 16.9%; and ischemic heart disease, 11.2%. Univariate logistic regression analysis identified the following risk factors with strongest impact on AF: left ventricular ejection fraction <40% (odds ratio (OR) = 1.951, 95% confidence interval (CI) 1.208–3.151), valvular heart disease (OR = 1.926, 95% CI 1.134–3.862), left ventricular ejection fraction 40–49% (OR = 1.743, 95% CI 1.248–3.017), HTN (OR = 1.653, 95% CI 1.092–3.458). History of ischemic stroke was present in 14.4% of the patients with AF. Oral antithrombotic drugs were prescribed to 85.7%: direct oral anticoagulants to 37.9%, vitamin K antagonists to 43.2%, and antiplatelets to 4.6%. Heart rate control medications and antiarrhythmics were prescribed to 75.4% and 40.2%, respectively. Conclusions: Atrial fibrillation was highly prevalent among our study population. Reduced and mid-range left ventricular ejection fraction, valvular heart disease, and HTN were the risk factors with the strongest association with AF. Although a large number of our AF patients were administered antithrombotic treatment, the prescription rate of oral anticoagulants should be further improved.


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