Differences in Left and Right Ventricular Function between Different Infarct Sites: An ECG-Gated Blood Pool Study

Background:Ventricular function is one of the important prognostic factors in patients with coronary artery disease. Among noninvasive approaches for the evaluation of ventricular performance, radionuclide ventr- iculography has shown to be of particular values in the patients with myocardial infarction. We have evaluated ventricular function with ECG-gated blood pool scan (GBPS in patients with myocardial infarction of different locations and compared right and left ventricular functions. Method:Left and right ventricular function was assessed with multigated blood pool scan in 49 patients at 2-3 weeks after acute myocardial infarction (anterior infarction=23, inferior infarction=19, and lateral infarction=7. Left ventricular ejection fraction (LVEF, right ventricular ejection fraction (RVEF, maximal emptying rate, maximal filling rate, phase angle and full width at half maximum (FWHM of phase angles were measured during rest. Results: 1 LVEF was significantly lower in the patients with anterior myocardial infarction (32.2% than that of inferior (46.5%, p<0.001 or lateral infarction (45.5%, p<0.05, but not different between inferior and lateral infarction. 2 RVEF was significantly lower in the patients with inferior myocardial infarction (24.6% than that of anterior (30.5%, p<0.05 or lateral infarction (36.1%, p<0.001, and RVEF of anterior infarction was significantly lower than that of lateral infarction (p<0.05. 3 Phase angle and FWHM of left ventricle and right ventricle phase histogram were not significantly different among the patients groups with different infarct sites. Conclusione:Ventricular function was differently affected by different infarct sites. Inferior infarction resulted in a greater reduction in right ventricular ejection fraction. In contrast, LVEF was greatly depressed in anterior infarction than in inferior infarction. (Korean Circulation J 1998;28(6 :871-878

[1]  J. López-Sendón,et al.  In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement. , 1997, Circulation.

[2]  A. Iskandrian,et al.  Prognostic value of simultaneous perfusion and function assessment using technetium-99m sestamibi. , 1996, The American journal of cardiology.

[3]  D. Schulman.  Assessment of the right ventricle with radionuclide techniques , 1996, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[4]  Y. Zhang,et al.  Assessment of ejection fraction of the right and left ventricles in patients with acute myocardial infarction by magnetic resonance imaging. , 1993, Japanese circulation journal.

[5]  J. Heo,et al.  Differentiation between primary dilated cardiomyopathy and ischemic cardiomyopathy based on right ventricular performance. , 1992, American heart journal.

[6]  L. Johnson,et al.  Effect of infarct size measured from antimyosin single-photon emission computed tomographic scans on left ventricular remodeling. , 1991, Journal of the American College of Cardiology.

[7]  Jaetae Lee,et al.  Evaluation of Coronary Artery Disease with Gated Blood Pool Scan Using Dipyridamole , 1991 .

[8]  D. Bonaduce,et al.  Diastolic function in acute myocardial infarction: a radionuclide study. , 1988, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[9]  J. Hung,et al.  Differences in left ventricular function between anterior and inferior myocardial infarction of equivalent enzymatic size. , 1987, International journal of cardiology.

[10]  M. Lee,et al.  Evaluation of Regional Wall Motion by Phase Analysis of Radionuclide Cardiac Blood Pool Scintigrams in Coronary Artery Disease Patients , 1987 .

[11]  B. Zaret,et al.  Right ventricular myocardial infarction with anterior wall left ventricular infarction: an autopsy study. , 1987, American heart journal.

[12]  G. Schuler,et al.  Effect of successful thrombolytic therapy on right ventricular function in acute inferior wall myocardial infarction. , 1984, The American journal of cardiology.

[13]  S. Goldstein,et al.  Sequential radionuclide angiographic assessment of left and right ventricular performance and quantitative thallium-201 scintigraphy following acute myocardial infarction. , 1984, American heart journal.

[14]  P. Rigo,et al.  Evaluation of right-ventricular function by gated blood-pool scintigraphy. , 1983, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  S. Goldstein,et al.  Comparison of radionuclide and enzymatic estimate of infarct size in patients with acute myocardial infarction. , 1983, Journal of the American College of Cardiology.

[16]  J M Links,et al.  Patterns of ventricular emptying by Fourier analysis of gated blood-pool studies. , 1980, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[17]  A. Gottschalk,et al.  Sequential radionuclide assessment of left and right ventricular performance after acute transmural myocardial infarction. , 1978, Annals of internal medicine.

[18]  H. Henning,et al.  Right Ventricular Ejection Fraction in Patients with Acute Anterior and Inferior Myocardial Infarction Assessed by Radionuclide Angiography , 1978, Circulation.