Simple and safe bedside method for serial measurement of left ventricular ejection fraction, cardiac output, and pulmonary blood volume.

A simple, safe method for bedside measurement of left ventricular function and pulmonary blood volume has been developed. A single scintillation probe positioned over the mid-left ventricle records the passage of bolus of radionuclide (ll3mIn) injected into the superior vena cava, from which the left ventricular ejection fraction can be determined after proper background correction. ll3mIn, half-life I-7 hours, easily prepared from a commercially available generator, rapidly binds to plasma transferrin and can be used to determine blood volume and cardiac output. With cardiac output and left ventricular ejection fraction determined simultaneously, left ventricular end-diastolic volume can be calculated and pulmonary blood volume can be determined from pulmonary transit time and cardiac output. With this method, we have demonstrated stable and changing left ventricular function and pulmonary blood volume in a variety of clinical situations, e.g. myocardial infarction, pulmonary embolism, and severe pulmonary parenchymal disease. Blood volume and cardiac output so determined correlate well with standard techniques. The left ventricular ejection fraction determined by this method correlates well with this measurement obtained from left ventricular angiography. Loss of the pulmonary valley between the right and left ventricles has been demonstrated in severe pulmonary vascular obstruction (embolism), in severe bronchial obstruction, and as a result of massive right ventricular dilatation in the presence of normal pulmonary blood volume. This method, which can be frequently performed, has proved useful in serial evaluation of cardiac function at the bedside.