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Phase and amplitude analysis of exercise digital left ventriculograms in patients with coronary disease
J Lyons1, M Norell, J Gardener
1Cardiac Department, London Chest Hospital.
Insights
Phase and amplitude analysis of digital left ventriculograms effectively detects exercise-induced myocardial ischemia in coronary artery disease patients. This method aids in assessing left ventricular wall motion changes after exercise.
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Coronary artery disease (CAD) diagnosis often relies on invasive procedures.
- Digital subtraction angiography can introduce artifacts, complicating analysis.
- Non-invasive assessment of myocardial ischemia is crucial for patient management.
Purpose of the Study:
- To evaluate the utility of phase and amplitude analysis of digital left ventriculograms.
- To assess exercise-induced changes in left ventricular wall motion.
- To determine if this method can detect myocardial ischemia in patients with CAD.
Main Methods:
- Intravenous digital left ventriculography was performed on 40 CAD patients and 8 controls.
- Studies were conducted before and after a symptom-limited supine bicycle exercise test.
- Phase and amplitude analyses were applied to the ventriculograms to assess wall motion.
Main Results:
- No deterioration in left ventricular wall motion was observed in controls post-exercise.
- 30 out of 40 CAD patients showed wall motion deterioration after exercise.
- Patients with more severe CAD (two- and three-vessel disease) predominantly exhibited wall motion changes.
Conclusions:
- Phase and amplitude analysis of digital left ventriculograms is a viable method for detecting exercise-induced myocardial ischemia.
- This technique can help assess left ventricular function and identify ischemia in CAD patients.
- It offers an alternative to potentially artifact-prone image subtraction methods.
Abstract:
Phase and amplitude analysis was applied to intravenous digital left ventriculograms to avoid the artefacts associated with image subtraction. Eight controls and 40 patients with known coronary artery disease underwent digital left ventriculography before and after a symptom limited supine bicycle exercise test. The resultant images were subjected to phase and amplitude analyses. In the control group there was no deterioration in left ventricular wall motion after exercise. In 30 of the 40 patients there was a deterioration in wall motion on exercise. This group contained all eight patients with three vessel disease and 12 of the 17 patients with two vessel disease. Ten patients showed no change in wall motion--five with one vessel disease and five with two vessel disease. Phase and amplitude analysis of digital left ventriculograms is a method of detecting exercise induced myocardial ischaemia that may help in the assessment of patients with coronary artery disease.