Mangschau A, Rollag A, Jonsbu J, Lund Karlsen R
Acta Med Scand. 1986;220(2):101-7. doi: 10.1111/j.0954-6820.1986.tb02737.x.
Left ventricular ejection fraction (EF) was determined by means of radionuclide ventriculography (RNV) in 477 patients 8-12 days after an acute myocardial infarction (AMI). EF was correlated to infarct size and clinical and radiological parameters of congestive heart failure (CHF). The 138 patients (29%) who had signs of CHF had a mean (+/- SD) EF of 35 +/- 14% and a relative heart volume of 597 +/- 112 ml/m2 compared to 51 +/- 14% and 487 +/- 88 ml/m2 among those without CHF. The 52 patients who also had radiological signs of CHF had a mean EF of 27 +/- 12% versus 35 +/- 14% among those with clinical signs and symptoms of CHF. Presence of CHF was positively correlated to the size of AMI and to the reduction of EF. CHF was seen with increasing frequency from 16% in small to 46% in large first infarctions. Patients with reinfarctions showed the same correlation between these parameters, however, with subsequently more depressed EF values and more frequent presence of CHF due to previous myocardial damage. CHF was seldom (8%) observed in patients with EF greater than 50%. In contrast, 67% of the patients with EF less than 35% had CHF. Thus patients with an EF less than 35% represent a high risk group with regard to development of CHF and should be followed closely. It is suggested that radionuclide measurement of EF adds important clinical information in patients with diagnostic uncertainty of CHF.
在477例急性心肌梗死（AMI）患者发病8 - 12天后，通过放射性核素心室造影（RNV）测定左心室射血分数（EF）。将EF与梗死面积以及充血性心力衰竭（CHF）的临床和放射学参数进行关联分析。138例（29%）有CHF体征的患者平均（±标准差）EF为35±14%，相对心脏容积为597±112 ml/m²，而无CHF的患者中这两个值分别为51±14%和487±88 ml/m²。52例同时有CHF放射学体征的患者平均EF为27±12%，而有CHF临床体征和症状的患者中该值为35±14%。CHF的存在与AMI面积大小以及EF降低呈正相关。CHF的发生率从小面积首次梗死的16%增加到大面积首次梗死的46%。再梗死患者的这些参数之间也存在相同的相关性，然而，由于既往心肌损伤，其EF值随后更低，CHF的发生率更高。EF大于50%的患者很少（8%）出现CHF。相反，EF小于35%的患者中有67%出现CHF。因此，EF小于35%的患者是发生CHF的高危人群，应密切随访。提示在CHF诊断存在不确定性的患者中，放射性核素测定EF可提供重要的临床信息。
