Extracting and analyzing ejection fraction values from electronic echocardiography reports in a large health maintenance organization

2016 ◽  
Vol 23 (4) ◽  
pp. 319-328 ◽  
Author(s):  
Fagen Xie ◽  
Chengyi Zheng ◽  
Albert Yuh-Jer Shen ◽  
Wansu Chen

The left ventricular ejection fraction value is an important prognostic indicator of cardiovascular outcomes including morbidity and mortality and is often used clinically to indicate severity of heart disease. However, it is usually reported in free-text echocardiography reports. We developed and validated a computerized algorithm to extract ejection fraction values from echocardiography reports and applied the algorithm to a large volume of unstructured echocardiography reports between 1995 and 2011 in a large health maintenance organization. A total of 621,856 echocardiography reports with a description of ejection fraction values or systolic functions were identified, of which 70 percent contained numeric ejection fraction values and the rest (30%) were text descriptions explicitly indicating the systolic left ventricular function. The 12.1 percent (16.0% for male and 8.4% for female) of these extracted ejection fraction values are <45 percent. Validation conducted based on a random sample of 200 reports yielded 95.0 percent sensitivity and 96.9 percent positive predictive value.

1988 ◽  
Vol 27 (02) ◽  
pp. 57-62
Author(s):  
R. Standke ◽  
R. P. Baum ◽  
S. Tezak ◽  
D. Mildenberger ◽  
F. D. Maul ◽  
...  

21 patients with LAD-stenoses of at least 70% and 21 patients with LAD- stenoses and additional intramural anterior wall infarctions were studied. 20 patients without heart disease or after successful transluminal coronary angioplasty and 18 patients with intramural anterior wall infarction after successful transluminal dilatation of the LAD (remaining stenosis maximal 30%) served as controls. The normal range of global and regional left ventricular ejection fraction response to exercise was defined based on the data of 25 further patients without relevant coronary heart disease. Thus, a decrease in global ejection fraction and regional wall motion abnormalities were judged pathological. All patients were comparable with respect to age, ejection fraction at rest and work load. Myocardial ischemia could be detected by the exercise ECG in 81 % of all patients without infarction and in 71 % of patients with infarction. The corresponding values for global left ventricular ejection fraction were 76% and 81 %, respectively, and for regional ejection fraction 95% in both groups. No false-positive exercise ECGs were observed in the healthy controls and 2 (11 %) in the corresponding group with intramural infarction. The global ejection fraction was pathological in 1 (5%) healthy subject without infarction and in 3 (17%) corresponding patients with infarction. Sectorial analysis revealed 5 and 22%, respectively. Our findings suggest that the exercise ECG has a limited sensitivity to detect myocardial ischemia in patients with isolated LAD-stenoses and intramural myocardial infarction. Radionuclide ventriculography yields pathological values more often; however, false-positive results also occur more frequently.


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.


2021 ◽  
Vol 33 (1) ◽  
pp. 12-18
Author(s):  
Abdullah Al Noman ◽  
Md Kamran Hasan ◽  
Md Arifuzzaman ◽  
Bhabananda Baroi ◽  
Md Titu Miah ◽  
...  

Objectives: To assess systolic left ventricular function determined by left ventricular ejection fraction (LVEF) with the help of Echocardiography and correlate with ECG findings in patients of AMI. Methods: One hundred (100) cases of acute myocardial infarction were studied in the Department of Cardiology, DMCH from July 2015 to December 2015. It was an observational study. All selected patients were interviewed with a preformed questionnaire and were observed up to 7 days in hospital. Echocardiography was done to assess left ventricular ejection fraction (LVEF) by applying Teichholz (cube) formula. Results: 83% of them were males and 17% of them were females. Mean age (±SD) was 52.24±11.59 years (range 34-82 years). The important risk factors among the study subjects, was hypertension (45%) (Male 40.96%; Female 64.7%) followed by Diabetes mellitus (33%) (Male 31.32%; Female 41.17%). Most of the admitted patients could reach in hospital within 4-12 hours of onset of symptoms and most of the patients of acute myocardial infarction had anterior wall involvement (37%). Mild systolic LV dysfunction (52.87%) was revealed in echocardiography among the survivors. Conclusion: The incidence of AMI was seen common among farmers who were mostly hypertensive. Systolic LV dysfunction was common in most patients where anterior wall involvement was present. Bangladesh J Medicine July 2022; 33(1) : 12-18


Author(s):  
V. I. Denesyuk ◽  
O. V. Denesyuk ◽  
N. O. Muzyka

Background. According to the national registries of European countries and epidemiological studies, the prevalence of chronic heart failure (CHF) among adults is 2,0-5,0%, and increases due to age, in people aged over 70 years old it is 10,0-20,0%.Objective. To find out the specific features of remodeling of the left atrium and change of vasodilation factors in ischemic heart failure with reduced and preserved left ventricular ejection fraction and to establish correlation relationships.Methods. A full clinical examination of 153 patients with CHF (105 men and 48 women) was conducted to achieve this objective. The surveyed patients underwent clinical examinations; spectrophotometric parameters: quantification of markers of vasodilation, metabolites of monoxide nitrogen – nitrates and nitrites with Gris reagent; content of endothelial nitric oxide synthase (eNOS) in serum - ELISA for the set of Nitric Oxide Synthase 3, Endothelial (NOS3) Human ELISA Kit (Cloud-Clone Corp, USA). Electrocardiographic (ECG) examination was conducted in 12 standard conventional leads on electrocardiograph by the Hungarian production Heart Screen 112 D.Results. The 1st group of the examined patients with reduced LV EF prevails III (significant) degree LA dilatation in 33 (70.21%) cases, II (moderate) degree of LA dilatation was determined in 14 (29.78%), and I (initial) degree was not defined at all. In the 2nd group of the patients with preserved LV EF mainly the II degree of LA dilatation was determined in 44 (44.51%) cases, and decreased LA dilation in 39 (36.79%) cases (p<0.01), and III degree of LA dilation was defined in 23 (21.69%) cases (p<0.01). In patients with stable coronary heart disease, complicated by heart failure with reduced LV EF and II degree of LA dilatation, eNOS levels in the serum was 449.00±39.91 pg/ml, whereas in patients with stable coronary heart disease, complicated by heart failure with preserved LV EF and II stage of LA dilatation – 673.56±50.98 pg/ml (p<0.01). At III stage of LA dilatation in patients of the 1st group level eNOS was 344.20±51.98 pg/ml in the patients of the 2nd group – 616.90±36.49 pg/ml (p<0.01). At the same degree and with LA dilation in the patients of the 2nd group eNOS was 750.27±99.85 pg/ml. Conclusions. The structural and functional changes of the left atrium and changing factors of vasodilation in patients with stable coronary artery disease of II-III functional classes complicated by heart failure of I-III functional classes are studied. It is established that in the examined patients with stable coronary heart disease complicated by heart failure with reduced left ventricular ejection fraction mainly III (significant) degree of dilatation of the left atrium was determined, while in patients with stable coronary heart disease, complicated by heart failure with preserved left ventricular ejection fraction mainly II (moderate) degree of dilation of the left atrium was determined. In comparison with the results of research among the patients with stable coronary heart disease, complicated by heart failure with reduced left ventricular ejection fraction, and a group of patients with preserved left ventricular ejection fraction, it was determined a significant decrease in eNOS, nitrites, total amount of nitrites and nitrates.


Author(s):  
Ika Ainur Rofi'ah ◽  
Eka Nur So'emah

Background: Cardiac rehabilitation is an evidence-based intervention that includes physical exercise, health education, and modification of health behavior in patients with cardiovascular disease. Cardiac rehabilitation is considered as secondary prevention after acute coronary syndrome and improves treatment outcomes in patients with coronary heart disease. This literature review aimed to evaluate the effectiveness of cardiac rehabilitation in coronary heart disease patients. Methods: This present study was a literature review discussing cardiac rehabilitation for coronary heart disease patients. Results: The result showed that the functional capacity of the CR group was more increased compared to non-CR (p <0.001; α <0.05), left ventricular ejection fraction (LVEF) significantly increased in the CR group (p < 0.05; α <0.05), the medical cost of CR group was lower significantly (p=0.042; α <0.05), and the risk of recurrence rate was significantly lower in CR group (p=0.004; α <0.05). Conclusions: Cardiac rehabilitation is known to increase functional capacity, increase left ventricular ejection fraction (LVEF), reduce medical costs, and reduce the recurrence rate of patients with CHD.


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