[The prognostic value of the ejection fraction at rest and under stress assessed by nuclear angiography in myocardial infarct patients].
BACKGROUND
The aim of this study was to assess the utility of ejection fraction at rest (rEF) and its change during stress (delta EF) as a predictor of cardiac events during the follow-up of patients (pts) with myocardial infarction.


METHODS
74 pts (44 treated with thrombolytic therapy (TR), and 30 not (noTR)), were studied with 99mTcPYP angiography within 2 +/- 1 months, after AMI. By 20 +/- 10 months, 41 pts had no events (Group A) while 33 pts experienced cardiac events (3 deaths, 16 angina, 12 CABG, and 2 PTCA).


RESULTS
rEF was similar in both Groups A and B (A 47 +/- 8 vs B 45 +/- 10 p. ns), 44 +/- 15 vs B-noTR 46 +/- 12 p. ns). delta EF was different between Groups A and B. Group A showed a positive delta EF (3.2 +/- 6), and this result was more evident in thrombolyzed AMI (A-TR 4.4 +/- 4.5 vs A-noTR 1.16 +/- 3.9 p. < 0.01). Group B showed a negative delta EF (-4.4 +/- 5.3), and this result was more evident in non thrombolyzed AMI (B-TR -2 +/- 6.4 vs B-noTR -5.8 +/- 8 p. < 0.01).


CONCLUSIONS
A decrease in EF during exercise radionuclide angiography is useful in identifying pts with high risk of cardiac events after AMI. Thrombolytic therapy improves stress EF in both Groups A and B.
Azzolini
P
P
Divisione di Cardiologia e UTIC, Ospedale S. Giovanni Calibita Fatebenefratelli, Isola Tiberina, Roma.
Speciale
G
G
Risa
M P
MP
Puglisi
A
A
Ricci
R
R
Neja
C P
CP
Fioranelli
M
M
Sgreccia
F
F
Uthurralt
N
N
Angrisani
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D011379:Prognosis; D011877:Radionuclide Imaging; D012146:Rest; D013300:Streptokinase / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects; D016698:Technetium Tc 99m Pyrophosphate; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D016698:Technetium Tc 99m Pyrophosphate; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Valore prognostico della frazione di eiezione a riposo e da sforzo valutata mediante angiografia nucleare in pazienti con infarto del miocardio.