G I Galasko1, S Basu, A Lahiri, R Senior. 1. Department of Cardiovascular Medicine, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
Abstract
OBJECTIVE: To characterise echocardiographic wall motion score index (WMSI) as a surrogate measure of left ventricular ejection fraction (EF) following acute myocardial infarction (AMI) and to compare its prognostic value with that of EF measured by radionuclide ventriculography (RNV). DESIGN: A prospective study to compare baseline echocardiographic WMSI with RNV EF in consecutive patients thrombolysed for AMI, both performed on the same day before discharge, and their relative prognostic values in predicting cardiac events. SETTING: District general hospital coronary care unit and cardiology department. PATIENTS: 120 consecutive patients free of exclusion criteria thrombolysed for AMI and followed up for a mean (SD) of 13 (10) months. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Correlation coefficients and receiver operating characteristic curve analyses plus cardiac event rates at follow up between RNV EF and echocardiographic WMSI. RESULTS: WMSI correlated well with RNV EF. The best corresponding WMSIs for EFs 45%, 40%, and 35% were 0.6, 0.8, and 1.1, respectively. There were 42 cardiac events during follow up. Although both RNV EF and WMSI were strong univariate predictors of cardiac events, only WMSI independently predicted outcome in a multivariate model. All three WMSI cut offs significantly predicted events, while an RNV EF cut off of </= 45% v > 45% failed to reach significance. CONCLUSIONS: Although both RNV and echocardiographic WMSI strongly predicted cardiac outcome, WMSI, a cheaper and more readily available technique, is more discriminatory, especially in cases of mild left ventricular dysfunction following AMI.
OBJECTIVE: To characterise echocardiographic wall motion score index (WMSI) as a surrogate measure of left ventricular ejection fraction (EF) following acute myocardial infarction (AMI) and to compare its prognostic value with that of EF measured by radionuclide ventriculography (RNV). DESIGN: A prospective study to compare baseline echocardiographic WMSI with RNV EF in consecutive patients thrombolysed for AMI, both performed on the same day before discharge, and their relative prognostic values in predicting cardiac events. SETTING: District general hospital coronary care unit and cardiology department. PATIENTS: 120 consecutive patients free of exclusion criteria thrombolysed for AMI and followed up for a mean (SD) of 13 (10) months. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Correlation coefficients and receiver operating characteristic curve analyses plus cardiac event rates at follow up between RNV EF and echocardiographic WMSI. RESULTS: WMSI correlated well with RNV EF. The best corresponding WMSIs for EFs 45%, 40%, and 35% were 0.6, 0.8, and 1.1, respectively. There were 42 cardiac events during follow up. Although both RNV EF and WMSI were strong univariate predictors of cardiac events, only WMSI independently predicted outcome in a multivariate model. All three WMSI cut offs significantly predicted events, while an RNV EF cut off of </= 45% v > 45% failed to reach significance. CONCLUSIONS: Although both RNV and echocardiographic WMSI strongly predicted cardiac outcome, WMSI, a cheaper and more readily available technique, is more discriminatory, especially in cases of mild left ventricular dysfunction following AMI.
Authors: R Senior; O Andersson; K Caidahl; P Carlens; M C Herregods; R Jenni; A Kenny; A Melcher; J Svedenhag; J L Vanoverschelde; B Wandt; B R Widgren; G Williams; P Guerret; K la Rosee ; L Agati; G Bezante Journal: Echocardiography Date: 2000-11 Impact factor: 1.724
Authors: P E Ureña; G A Lamas; G Mitchell; G C Flaker; S C Smith; F J Wackers; P McEwan; M A Pfeffer Journal: J Am Coll Cardiol Date: 1999-01 Impact factor: 24.094
Authors: F J Wackers; H J Berger; D E Johnstone; L Goldman; L A Reduto; R A Langou; A Gottschalk; B L Zaret Journal: Am J Cardiol Date: 1979-06 Impact factor: 2.778
Authors: R Koch; R M Lang; M J Garcia; L Weinert; J Bednarz; C Korcarz; B Coughlan; A Spiegel; E Kaji; K T Spencer; V Mor-Avi Journal: J Am Coll Cardiol Date: 1999-08 Impact factor: 24.094
Authors: K Jensen-Urstad; F Bouvier; J Höjer; H Ruiz; J Hulting; B Samad; C Thorstrand; M Jensen-Urstad Journal: Am J Cardiol Date: 1998-03-01 Impact factor: 2.778
Authors: Vivian G Ng; Alexandra J Lansky; Stephanie Meller; Bernhard Witzenbichler; Giulio Guagliumi; Jan Z Peruga; Bruce Brodie; Ruchit Shah; Roxana Mehran; Gregg W Stone Journal: Eur Heart J Acute Cardiovasc Care Date: 2013-10-03
Authors: Agnes Mayr; Kathrin Pedarnig; Gert Klug; Michael Schocke; Otmar Pachinger; Werner Jaschke; Bernhard Metzler Journal: Int J Cardiovasc Imaging Date: 2011-10-01 Impact factor: 2.357
Authors: Cameron J Holloway; Lindsay M Edwards; Oliver J Rider; Angela Fast; Kieran Clarke; Jane M Francis; Saul G Myerson; Stefan Neubauer Journal: Int J Cardiovasc Imaging Date: 2010-10-01 Impact factor: 2.357
Authors: Nripesh Parajuli; Allen Lu; Kevinminh Ta; John Stendahl; Nabil Boutagy; Imran Alkhalil; Melissa Eberle; Geng-Shi Jeng; Maria Zontak; Matthew O'Donnell; Albert J Sinusas; James S Duncan Journal: Med Image Anal Date: 2019-04-18 Impact factor: 8.545