Right ventricular ejection fraction in patients with acute anterior and inferior myocardial infarction assessed by radionuclide angiography

Abstract

We measured right and left ventricular ejection fracttion (EF) from high frequency time-activity curves obtained during the initial passage of an intravenous bolus of 99mTc (Sn) pyrophosphate. In 22 normal controls right ventricular EF averaged 0.52 +/- 0.04 (SD). In 24 acute anterior or lateral infarction patients right ventricular EF was normal (0.56 +/- 0.10), while left ventricular EF was reduced (0.45 +/- 0.10, P less than 0.001 vs controls). In 19 acute inferior infarction patients left ventricular EF also was depressed (0.51 +/- 0.09, P less than 0.001 vs controls). Among 7 of 19 inferior infarction patients with right ventricular by scintigraphy, right ventricular EF was reduced (0.39 +/- 0.05; P less than 0.001 vs normals; P less than 0.01 vs inferior infarction patients without right ventricular involvement). In the latter group right ventricular EF averaged 0.51 +/- 0.10 (NS vs normals). We conclude 1) a single injection of 99mTc (Sn) pyrophosphate can identify right and left ventricular dysfunction and infarct location in acute myocardial infarction, 2) right ventricular EF is well-preserved except when inferior infarction involves the right ventricle.