[Echocardiographic study of left ventricular contraction by a scoring method in chronic coronary insufficiency]

The echocardiographic evaluation of left ventricular function in chronic coronary insufficiency is based on the two-dimensional ultrasound examination. Several methods of analysis can be used: volumetric analysis or comparison of the diastolic and systolic contours after separation of the images, but they are relatively difficult to perform and are associated with a certain degree of error. We present the results of a method of analysis based on scoring of the real time image without reprogramming. The left ventricle is divided into nine parts according to Heger's model and the segmental kinetics of each segment are scored according to the following system; 0: parietal aneurysm; 1: dyskinesia; 2: akinesia; 3: hypokinesia; 4: normal. The maximal score is therefore 36. This method was applied prospectively in 30 consecutive patients with chronic coronary insufficiency requiring coronary angiography. The results were compared to those of ventriculography in 30 degrees RAO and 45 degrees LAO cranio-caudal views, which were analysed quantitatively. A correct echocardiographic analysis was obtained in 29 patients. There was good concordance with the ventriculography in 20 cases. In two cases, the contractile abnormality was detected on the echocardiogram, but it was located in an adjacent area on the angiography. In five cases, a localised abnormality of one segment was only detected on angiography. The comparison of the score with the angiographic ejection fraction revealed a good concordance and a very high degree of sensitivity for the method in the identification of cases with an ejection fraction of less than 30 p. cent. This scoring method avoids a number of errors of the other volumetric methods or the methods which compare the contours and it provides clinically significant results.(ABSTRACT TRUNCATED AT 250 WORDS)