Quantitative two-dimensional echocardiographic assessment of left ventricular shape in ischemic heart disease

Since data on systematic noninvasive quantitative assessment of left ventricular (LV) shape in ischemic heart disease are very scanty, we used new size-independent LV shape descriptors to study the correlation between LV shape and LV ejection fraction in 46 men with a 70% or more stenosis of one or more coronary arteries on angiography. Angiocardiographic LV ejection fraction was over 55% [mean: 69 (+/- 6 SD)%] in 20 patients (group I), and under 55% [mean: 43 (+/- 9 SD)%] in 26 patients (group II). Our LV shape descriptors showed statistically significant differences between group I and group II patients, indicating a more spherical LV shape in group II (p values less than 0.005). Within the whole patient group (N = 46), and also within the subgroup of patients with regional LV hypokinesis or akinesis (N = 26), correlation between LV shape alteration (toward the spherical) and LV ejection fraction was not strong; it was better in the subgroup (N = 10) with regional LV wall dyskinesis. There was poor correlation between angiocardiographic LV chamber volume and alteration (toward spherical) in LV shape. Thus, we have documented quantitatively that patients with ischemic heart disease and low LV ejection fraction tend to have a more spherical LV shape than patients with a normal ejection fraction. Quantification of LV shape based on simple, easily made two-dimensional echocardiographic measurements may help in noninvasive identification of patients with deteriorating LV function, especially when a change toward the spherical is detected in serial echocardiograms.