Location of myocardial necrosis as an independent determinant of left ventricular performance: analysis of 96 patients.
This study determines whether the location of myocardial scarring has an effect independent of its size on left ventricular (LV) ejection fraction (EF) in patients with coronary artery disease. Two groups of patients were studied: Group I (n = 44) had resting thallium-201 perfusion defects involving the anterior wall or septum or both, and Group II (n = 52) had perfusion defects involving the inferior wall or posterior wall or both. The thallium images were divided into 5 segments in each of 3 projections, and the thallium score was determined from the number of abnormal segments and the degree of reduction of thallium uptake; the higher the score, the more severe the perfusion deficit. If the thallium score was less than or equal to 10, EF was 45 +/- 14% (mean +/- standard deviation) in Group I and 47 +/- 11% in Group II (p = not significant [NS]). If the thallium score was greater than 10, EF was 30 +/- 12% in Group I and 32 +/- 11% in Group II (NS). Similarly, EF was not significantly different between the 2 groups when the perfusion defects were assessed by the number of abnormal segments. In each group EF was significantly lower as the number of abnormal segments increased or as the thallium score was higher (p less than 0.01). The results were unchanged when patients with resting ischemic defects or women were excluded. Thus, the location of myocardial scar itself is not important in determining LV function. However, the size of the scar is important in determining LVEF.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013318:Stroke Volume; D013793:Thallium
D011868:Radioisotopes; D013793:Thallium