Slutsky R, Gordon D, Karliner J, Battler A, Walaski S, Verba J, Pfisterer M, Peterson K, Ashburn W
Am J Cardiol. 1979 Sep;44(3):459-65. doi: 10.1016/0002-9149(79)90397-7.
To identify abnormal left ventricular function without exercise stress in patients with coronary artery disease first-pass radionuclide angiograms were analyzed in 32 normal subjects (Group I); 31 patients with coronary disease and normal contrast ventriculograms (Group II); and 17 patients with coronary disease and depressed left ventricular function (Group III). Total ejection fraction (EF) was computed with standard angiographic methods and from each time-activity curve. During the first third of systole, ejection fraction was determined manually by averaging three to five beats and the value compared with that obtained with contrast ventriculography: (Formula: see text). Both total radionuclide ejection fraction (r = 0.95) and first-third ejection fraction (r = 0.91) correlated well with angiography. Intraobserver and interobserver variation was small, averaging 0.02 +/- 0.02 (range 0 to 0.05). The radionuclide first-third ejection fraction was 0.25 or greater in normal subjects and less than 0.25 in 29 of 31 patients (94 percent) in Group II and in all patients in Group III. It is concluded that the first-third ejection fraction obtained with first pass angiography identifies subtle abnormalities of left ventricular function at rest in more than 90 percent of patients with coronary disease that may not be recognized by total ejection fraction alone.
为了在无运动负荷的情况下识别冠心病患者左心室功能异常，对32名正常受试者（第一组）、31名冠心病且对比心室造影正常的患者（第二组）以及17名冠心病且左心室功能降低的患者（第三组）的首次通过放射性核素血管造影进行了分析。用标准血管造影方法并从每条时间-活性曲线计算总射血分数（EF）。在收缩期的前三分之一期间，通过平均三到五个心动周期手动确定射血分数，并将该值与对比心室造影获得的值进行比较：（公式：见正文）。放射性核素总射血分数（r = 0.95）和前三分之一射血分数（r = 0.91）与血管造影的相关性都很好。观察者内和观察者间的差异很小，平均为0.02±0.02（范围0至0.05）。正常受试者的放射性核素前三分之一射血分数为0.25或更高，第二组31名患者中的29名（94%）以及第三组所有患者的该射血分数均小于0.25。结论是，首次通过血管造影获得的前三分之一射血分数可识别出超过90%的冠心病患者静息时左心室功能的细微异常，而这些异常可能仅通过总射血分数无法识别。
