title: Quantitative measures of regional asynergy add independent prognostic information to left ventricular ejection fraction in patients with prior myocardial infarction.
abstract: The purpose of this study was to determine if quantitative measurements of regional asynergy add independent prognostic information to global ejection fraction in patients with chronic coronary artery disease. Four hundred eighty-six patients with a history of Q-wave myocardial infarction who underwent gated-equilibrium radionuclide angiography at least 3 months after infarction were monitored for a median duration of 4.7 years. During follow-up there were 95 deaths. Four of five regional asynergy indexes analyzed were associated with overall mortality. The strength of the association between overall mortality and the index that proved to be optimal (univariate chi2 = 26.4, p < 0.001) was stronger than for global ejection fraction (univariate chi2 = 21.5, p < 0.001). For patients with global ejection fraction <40%, 4-year survival was 87% for those with a low asynergy index versus 65% for those with a high asynergy index (p = 0.016). In conclusion, indexes of regional asynergy add independent prognostic information to global left ventricular ejection fraction.
authors.affiliation: Division of Internal Medicine, Mayo Clinic, Rochester, Minn. 55905, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Miller
authors.forename: A M
authors.initials: AM
authors.lastname: Weissler
authors.forename: T F
authors.initials: TF
authors.lastname: Christian
authors.forename: K R
authors.initials: KR
authors.lastname: Bailey
authors.forename: R J
authors.initials: RJ
authors.lastname: Gibbons
mesh_terms: D000704:Analysis of Variance; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging / Q000503:physiopathology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D016037:Single-Blind Method; D013318:Stroke Volume; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left