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Comparison of measurements of left ventricle by echography and cineangiography
Insights
Echocardiography accurately estimates left ventricular dimensions and volumes, but may underestimate larger sizes. New formulas derived from echocardiography allow for relatively accurate volume predictions.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Echocardiography is a non-invasive imaging technique used to assess cardiac function.
- Cineangiocardiography is an invasive method for evaluating cardiac structures and function.
- Accurate estimation of left ventricular dimensions and volumes is crucial for diagnosing and managing heart conditions.
Purpose of the Study:
- To compare the accuracy of echocardiography and cineangiocardiography in estimating left ventricular dimensions and volumes.
- To derive and validate new formulas for calculating left ventricular volumes using echocardiographic data alone.
- To compare echocardiographic and cineangiographic measurements of ejection fraction and myocardial contractility.
Main Methods:
- Echocardiography and cineangiocardiography were performed on 43 patients with varying left ventricular pathophysiology.
- New formulas were derived from the long-to-short axis ratio for calculating end-diastolic volume (EDV) and end-systolic volume (ESV).
- Ejection fraction (EF), relative changes in internal diameter (delta S), and mean velocity of circumferential fiber shortening (mean Vcf) were compared between the two methods in 33 patients with sinus rhythm.
Main Results:
- High correlations were observed between echocardiographic and angiographic minor axis dimensions, with underestimation by echocardiography when dimensions exceeded 5.0 cm.
- Derived formulas (EDV = 0.837 Dd-3, ESV = 0.994 Ds-3) allowed relatively accurate volume predictions across a range of ventricular sizes, validated against established formulas.
- Significant correlations were found between echocardiographic EF and mean Vcf, with one exception in aortic insufficiency where decreased mean Vcf was noted despite a normal EF.
Conclusions:
- Echocardiography provides a reliable method for estimating left ventricular dimensions and volumes, with derived formulas enhancing accuracy.
- The study highlights potential underestimation of dimensions by echocardiography in significantly enlarged ventricles.
- A discrepancy between EF and mean Vcf in aortic insufficiency may be attributed to prolonged ejection time, underscoring the importance of considering specific pathologies.
Abstract:
A comparison of echocardiography with cineangiocardiography in estimating left ventricular dimensions and volumes was undertaken in 43 patients classified into four groups according to the pathophysiology of the left ventricle. There were high correlations between echographic and angiographic ventricular minor axis dimensions, however, when minor axis dimensions were more than 5.0 cm, there were underestimations of minor axis dimensions by echography. From the mean value of long-to-short axis ratio of the left ventricle at end-diastole and end-systole, the following equations were derived for calculating left ventribular volumes from echo dimensions alone: EDV equals 0.837 Dd-3, ESV equals 0.994 Ds-3. That these equations allowed relatively accurate prediction of volumes over a wide range of ventricular sizes was confirmed by comparison with Pombo's formula and Fortuin's formula for calculating left ventricular volume by echo dimensions alone. A comparison of echographic and cineangiographic ejection fraction (EF), relative changes in shortening of internal diameter (delta S), and the mean velocity of circumferential fiber shortening (mean Vcf) was made i; 33 patients with sinus rhythm. There were significant correlations between EF and mean Vcf by echocardiography, except one discordant patient with aortic insufficiency who showed decreased mean Vcg in the face of normal EF, all these results were confirmed by cineangiography. This discrepancy between EF and mean Vcf was ascribed to the prolonged ejection time which characterizes aortic insufficiency.