Skali et al used echocardiography to evaluate patients 1 year after a myocardial infarction. This can help identify patients at increased risk for an adverse cardiac event. The authors are from Harvard Medical School, Botucatu (Sao Paulo), London Health Science Center (Ontario), Mount Sinai Medical Center (Miami Beach), University of Texas Houston, University of Pennsylvania, University of Montreal and the Memorial University of Newfoundland.

Adverse cardiac events: heart failure (HF), recurrent myocardial infarction, death


The followup period was 22 months after the echocardiography (about 3 years after the acute myocardial infarction).



(1) left ventricular ejection fraction

(2) right ventricular function, as measured by the fractional area change (FAC)


left ventricular volume =

= 0.85 * ((area)^2) / (length)


left ventricular ejection fraction =

= 100% * ((diastolic volume) - (systolic volume)) / (diastolic volume)


fractional area change =

= 100% * ((end diastolic area) - (end systolic area)) / (end diastolic area)




Hazard Ratio for Death or HF

left ventricular ejection fraction

> 30%



<= 30%


right ventricular fractional area change

>= 32.2%



< 32.2%




• The cutoff point for determining right ventricular dysfunction was a fractional area change 2 standard deviations below the mean.

• The end-point reported is for death and/or heart failure.

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