Correlation of ejection fraction and infarct size estimated from the total CK released in patients with acute myocardial infarction.

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Abstract
To study the relation between infarct size in acute myocardial infarction [AMI] and left ventricular ejection fraction early after recovery, total creatine kinase [CK] released was calculated by the modified Sobel method from the serial determinations of serum CK activity. Left ventriculography and selective coronary arteriography were performed at a mean of 2 mo. after the onset of infarction in 34 patients with AMI. Of 34 patients, 32 (94%) had left ventricular asynergy. In 21 patients with akinesis and/or dyskinesis a significant correlation was found between the extent of the non-contracting segment of the left ventricle and left ventricular ejection fraction. Apparently the extent of the non-contracting segment contributes largely to reduction of ejection fraction in patients with AMI. A close inverse correlation was seen between infarct size and ejection fraction after anterior and after inferior infarction; cardiac index was maintained over 2.0 l/min per m2 in all except 3 patients. The ejection fraction in patients with anterior myocardial infarction was lower than in those patients with inferior myocardial infarction with comparable values of total CK released. This was true even after exclusion of 6 patients with proximal right coronary artery lesions who might have had right and left ventricular necrosis; left ventricular function after infarction depends in part on the site of the infarct.