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Prompt return to normal of depressed right ventricular ejection fraction in acute inferior infarction.

A relatively simple, bedside, radionuclide technique has been developed to measure right ventricular ejection fraction. This technique uses a collimated scintillation probe (5 x 5 cm sodium iodide crystal) and 113mIndium injected into the superior vena cava to record a right ventricular time-activity curve. The radionuclide method was validated in 34 men (14 normals, 20 with coronary artery disease) with biplane right ventriculography (r= 0 82). Using this radionuclide method right ventricular ejection fraction was measured in 26 men (average age 51 years) with an acute transmural myocardial infarction. Right ventricular ejection fraction was initially depressed (0 40±0 02; mean±SEM; normal 0-57±0-01) in all of 11 men with an acute inferior infarction but returned to normal by the third day in 10 of them (0-58±0.01; NS). In the 15 men with an acute anterior infarction the average right ventricular ejection fraction was normal initially (0.54+ 0*01; NS) and individually 10 of 15 had a normal ejection fraction. Left ventricular ejection fraction was initially depressed in allpatients and only 4 of 34 (12%) had returned to normal at the third day. These results suggest that right ventricular ejection fraction is regularly depressed in patients with an acute inferior inifarction but normal in those with an anterior infarction. Right ventricular performance rapidly im-proves after inferior infarction; whereas less improvement occurs in left ventricular ejection fraction. Left ventricular ejection fraction to