Quantitative left ventricular wall motion analysis: a comparison of area, chord and radial methods

We were interested in divising a relatively simple quantitative technique that could be used on a routine clinical basis for wall motion analysis. Three quantitative methods of left ventricular (LV) regional analysis were compared in the 30 degrees right anterior oblique and 60 degrees left anterior oblique projection. The control group consisted of 17 patients with qualitatively normal LV wall motion; the abnormal group comprised 17 patients with at least one region of severe, qualitative wall motion abnormality. Normal regional values were determined for area, chord and radial methods by applying the techniques to the ventriculograms of the control group. Each technique was then applied to the abnormal group's ventriculograms to determine the percentage of qualitatively abnormal regions not detected by each method. The area method had the lowest failure rate (p less than 0.001) and the best separation of measured normal and abnormal regions' ejection changes (p less than 0.001), and best reflected symmetric uniform motion of the ventricular silhouette. We conclude that the area method, of the techniques examined, was best for the quantitative analysis of LV wall motion abnormalities.