Jain A P, Gupta O P, Jajoo U N, Kumar A, Trivedi S K
Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Dist. Wardha, M.S.
J Assoc Physicians India. 1993 Jan;41(1):17-9.
In 43 rural patients, all survivors of acute Myocardial infarction, left ventricular function was studied by 2-D echocardiography and evaluated in relation to 18 clinical predictors of left ventricular function. The mean left ventricular ejection fraction (LVEF) was 41.53 +/- 12.92% as compared to 70.02 +/- 7.02% in 506 healthy controls. LVEF was dichotomised at < 40% (n = 24) and > 40% (n = 19). Out of various clinical variables analysed following were found to be strong predictors of low LVEF. S3 gallop (p < 0.001) pulmonary rates (p < 0.001); Creatine phosphokinase > 200 I.U. (p < 0.001); Cardiomegaly on X-ray (p < 0.001); pulmonary congestion on chest X-ray (p < 0.001); and proportional pulse pressure (p < 0.001). There was a stepwise decline in the LVEF for each additional clinical variable. The over all predictive accuracy was 90%. It is concluded that readily obtainable clinical variables provide a useful bedside method of estimating LVEF after acute myocardial infarction.
对43例急性心肌梗死存活的农村患者，采用二维超声心动图研究其左心室功能，并与18项左心室功能临床预测指标进行相关性评估。这些患者的平均左心室射血分数（LVEF）为41.53±12.92%，而506名健康对照者的平均左心室射血分数为70.02±7.02%。LVEF以<40%（n = 24）和>40%（n = 19）进行二分法划分。在分析的各种临床变量中，发现以下因素是低LVEF的强预测指标：S3奔马律（p < 0.001）、肺部啰音（p < 0.001）；肌酸磷酸激酶>200国际单位（p < 0.001）；X线显示心脏扩大（p < 0.001）；胸部X线显示肺淤血（p < 0.001）；以及脉压比值（p < 0.001）。每增加一项临床变量，LVEF就会逐步下降。总体预测准确率为90%。结论是，易于获得的临床变量为急性心肌梗死后估计LVEF提供了一种有用的床边方法。
