Author + information
- Received November 9, 1982
- Revision received February 8, 1983
- Accepted February 11, 1983
- Published online July 1, 1983.
- G. B. John Mancini, MD, FRCP (C)*,1,
- Sharon L. Norris, MD,
- Kirk L. Peterson, MD, FACC,
- Gabriel Gregoratos, MD, FACC,
- Thomas F. Widmann, MD,
- William L. Ashburn, MD and
- Charles B. Higgins, MD, FACC
- ↵*Address for reprints: G. B. John Mancini, MD, Division of Cardiology (H-811A), University Hospital, 225 Dickinson Street, San Diego, California 92103.
Digital intravenous ventriculography lends itself readily to quantitative assessment of ventricular wall motion with computer algorithms. Forty-five patients referred for cardiac catheterization were studied by digital intravenous ventriculography (mask mode) and direct ventriculography in the 30° right anterior oblique position. Quantitative wall motion was analyzed by a radial shortening method applied to both studies. Lower limits of normal radial shortening were determined for each technique and used to determine the presence or absence of wall motion disorders. The inter- and intraobserver variability of radial shortening measurements was ± 5.3 and ± 8.8%, respectively, with maximal discrepancies of - 6 and + 7% fractional shortening units. The overall agreement between the two techniques in wall motion assessment was 87% (274 of 315 radii). A subset of patients also underwent atrial pacing, and a second digital intravenous ventriculogram was obtained (5 normal subjects and 15 patients with coronary artery disease). Although analysis of wall motion at rest showed a poor sensitivity for detection of significant coronary stenoses, nine of nine patients with coronary artery disease and normal wall motion at rest showed a quantitative decrease in radial wall motion after atrial pacing.
Thus, digital intravenous ventriculograms can be used to provide quantitative wall motion analyses that show a high degree of agreement with those of standard, direct left ventriculography. Atrial pacing can be used to increase the sensitivity of wall motion analysis for the detection of significant coronary disease.
with the technical assistance of Ellen Einsidler, RT
- Received November 9, 1982.
- Revision received February 8, 1983.
- Accepted February 11, 1983.
- American College of Cardiology Foundation