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QUANTITATIVE ASSESSMENT OF LEFT VENTRICULAR ASYNERGY
Pedro R. Hernandez-Lattuf1, Efrain Garcia, Jose Suarez De Lezo
1Clayton Foundation Cardiovascular Laboratory, St. Luke's Episcopal Hospital and the Texas Heart Institute, Houston, Texas.
Cardiovascular Diseases
|January 1, 1976
Summary
Analyzing myocardial performance in the human heart, this study found that hemichord velocity is crucial for detecting regional contraction abnormalities. Standard ejection fraction and normalized ejection rate have low sensitivity for segmental asynergy.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Assessing intact human heart myocardial performance relies on ejection phase indices.
- Biplane left ventricular cineangiocardiography is a key diagnostic tool.
Purpose of the Study:
- To quantitatively evaluate left ventricular contraction characteristics.
- To assess the sensitivity of various indices in detecting myocardial dysfunction, particularly segmental asynergy.
Main Methods:
- 18 patients with high-quality biplane left ventricular cineangiocardiograms were analyzed.
- Quantitative measures included systolic ejection fraction, mean velocity of circumferential fiber shortening (V(CF)) at the equator and chords, mean normalized systolic ejection rate, and hemichord shortening velocity.
Main Results:
- All 18 patients exhibited contraction abnormalities based on hemichord velocity.
- Ejection fraction and mean normalized systolic ejection rate demonstrated low sensitivity for detecting depressed myocardial function in segmental asynergy.
- Equatorial V(CF) offered limited additional information unless affected areas were near the minor axis.
- Segmental V(CF) significantly improved sensitivity, but hemichord velocity was superior for single-wall motion abnormalities.
Conclusions:
- Hemichord velocity is a sensitive indicator of regional myocardial contraction abnormalities.
- Standard ejection phase indices like ejection fraction and normalized ejection rate have limitations in detecting segmental asynergy.
- Segmental V(CF) enhances detection, but hemichord velocity provides better regional assessment, especially in cases of isolated wall dysfunction.