An Indirect Method for Evaluation of Left Ventricular Function in Acute Myocardial Infarction

An indirect estimate of the contractility index, max LV dP/dt/LVEDP, has been examined in 32 patients following acute myocardial infarction (AMI) and in three patients with acute coronary insufficiency (ACI). The index was derived from arterial diastolic pressure (DP) obtained by sphygmomanometer, left ventricular filling pressure (LVFP) obtained by pulmonary artery balloon catheter, and preejection period (PEP) determined from the phonocardiogram, carotid pulse, and ECG. These data were used in the relation (DP-LVFP)/PEP/LVFP (i.e., ΔP/Δt/LVFP) as an approximation of the direct contractility index max dP/dt/LVEDP. While measurements of PEP, DP, and LVFP used independently were not useful in distinguishing patients grouped in surviving AMI, nonsurviving AMI, and ACI categories, the ΔP/Δt/LVFP index showed marked separation of these groups. Because of the simplicity of measurement and minimal intravascular intervention, the index provides a safe and practical means of assessing the degree of left ventricular dysfunction in patients with AMI.