Joffe Samuel W, Chalian Armen, Tighe Dennis A, Aurigemma Gerard P, Yarzebski Jorge, Gore Joel M, Lessard Darleen, Goldberg Robert J
Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
Am Heart J. 2009 Aug;158(2):185-92. doi: 10.1016/j.ahj.2009.05.027.
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.
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.
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.
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.
尽管当前指南强烈建议对所有因急性心肌梗死（AMI）住院的患者进行射血分数（EF）测量，但描述这些患者中用于评估EF的诊断方式使用趋势的数据有限。本研究的目的是评估在因AMI住院的社区患者样本中，使用心室造影和超声心动图测量EF的趋势。
回顾了1997年至2005年间在伍斯特（马萨诸塞州）大都市地区11家更大的伍斯特医疗中心因AMI住院的5380名居民的病历。
1997年至2005年间，通过心室造影和超声心动图测量EF的AMI住院患者比例从11%增至18%，而未通过任何一种方式接受EF评估的患者比例从37%降至27%。仅通过心室造影测量EF的患者比例从14%增至20%，而仅通过超声心动图测量EF的患者比例稳定在37%。1997年，约三分之二的住院患者在心室造影前进行了超声心动图检查，而2005年，约三分之二的AMI患者在超声心动图检查前进行了心室造影。
在AMI患者中，使用左心室造影以及同时使用心室造影和超声心动图评估EF的情况正在增加。尽管近年来未评估EF的患者比例有所下降，但仍有许多患者未接受EF测定。
