Trends in the use of echocardiography and left ventriculography to assess left ventricular ejection fraction in patients hospitalized with acute myocardial infarction.
BACKGROUND
Although current guidelines strongly recommend the measurement of ejection fraction (EF) in all patients hospitalized with acute myocardial infarction (AMI), there are limited data available describing trends in the use of diagnostic modalities to assess EF in these patients. The purpose of this study was to evaluate trends in the use of ventriculography and echocardiography to measure EF in a community sample of patients hospitalized with AMI.


METHODS
The medical records of 5,380 residents of the Worcester (MA) metropolitan area hospitalized with AMI at 11 greater Worcester medical centers between 1997 and 2005 were reviewed.


RESULTS
Between 1997 and 2005, the proportion of patients hospitalized with AMI undergoing measurement of EF by both ventriculography and echocardiography increased from 11% to 18%, whereas the percentage of patients who did not receive an evaluation of EF by either modality decreased from 37% to 27%. The percentage of patients undergoing measurement of EF by ventriculography alone increased from 14% to 20%, whereas the percentage of patients undergoing measurement of EF by echocardiography alone remained stable at 37%. In 1997, echocardiography was performed before ventriculography in approximately two thirds of hospitalized patients, whereas in 2005, ventriculography was performed before echocardiography in approximately two thirds of patients with AMI.


CONCLUSIONS
The use of left ventriculography and the concurrent use of both ventriculography and echocardiography to assess EF in patients with AMI are increasing. Although the proportion of patients who do not have their EF assessed has declined during recent years, many still do not receive a determination of their EF.
Joffe
Samuel W
SW
Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
Chalian
Armen
A
Tighe
Dennis A
DA
Aurigemma
Gerard P
GP
Yarzebski
Jorge
J
Gore
Joel M
JM
Lessard
Darleen
D
Goldberg
Robert J
RJ
D000368:Aged; D004452:Echocardiography / Q000639:trends*; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000639:trends*; D006801:Humans; D008297:Male; D008404:Massachusetts; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left / Q000502:physiology