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[Differential analysis of ventricular contraction using digital subtraction angiography]
Insights
This study demonstrates that iodinated contrast dye digital subtraction angiography (I-V DSA) with Fourier transform analysis can effectively identify abnormal cardiac contraction patterns in patients with various heart conditions. The method precisely defines delays, dyskinesias, and rhythm disturbances, aiding in diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Standard diagnostic methods for cardiac abnormalities have limitations.
- Assessing ventricular function requires precise analysis of myocardial movement.
- Digital subtraction angiography (DSA) offers advanced imaging capabilities.
Purpose of the Study:
- To evaluate the utility of iodinated contrast dye digital subtraction angiography (I-V DSA) in analyzing cardiac contraction.
- To characterize abnormal ventricular function using Fourier transform-based amplitude and phase analysis.
- To correlate specific contraction patterns with diagnosed cardiac abnormalities.
Main Methods:
- 136 patients with cardiac abnormalities and 35 controls underwent I-V DSA.
- Left and right ventricular images were analyzed using Fourier transform for amplitude and phase.
- Temporal differentiation of ventricular function and myocardial movement amplitude were assessed.
Main Results:
- Hypokinetic segments showed delayed contraction.
- Dyskinesias exhibited separated maximal phases with phase histogram peaks.
- Cardiac rhythm disturbances displayed distinct contraction initiation sites (e.g., Wolfe-Parkinson-White syndrome, bundle branch block, VVI stimulation, hypertrophic obstructive cardiomyopathy).
Conclusions:
- Differential phase analysis of I-V DSA provides a straightforward method for defining cardiac contraction.
- This technique effectively differentiates various types of abnormal myocardial motion and rhythm disturbances.
- I-V DSA analysis offers valuable insights into the mechanics of cardiac abnormalities.
Abstract:
One hundred and thirty-six patients with various cardiac abnormalities that had been diagnosed by standard methods, were examined by I-V DSA; images of the left and right ventricles during a representative cardiac cycle were submitted to amplitude and phase analysis, using a Fourier transformation. Temporal differentiation of ventricular function was derived from the best available right anterior oblique projection; the amplitude of cardiac movement of abnormal areas in the myocardium were obtained from a grey scale or colour coding at a fixed point. Comparison with a control group of 35 individuals showed the following pathological findings: hypokinetic segments (33 cases) showed delay, dyskinesias (20 cases) showed complete separation of maximal phases, frequently with a double peak in the phase histogram; disturbances of cardiac rhythm (14 cases) showed atypical localisation of initiation of contraction: in Wolfe-Parkinson-White syndrome this is basal-anterior, in left bundle branch block and VVI stimulation it is apical inferior; in hypertrophic obstructive cardiomyopathy (eight cases) it is postero-basal inferior with high, narrow peaks on the phase histogram. Differential phase analysis on I-V DSA enables one to define cardiac contraction in a simple manner.