Related Experiment Videos
Left ventricular performance in various heart diseases with or without heart failure:--an appraisal by quantitative
Insights
Assessing left ventricular (LV) function requires evaluating ejection fraction (EF), mean velocity of circumferential fiber shortening (VCF), and wall motion abnormalities. These three ejection properties are crucial for understanding LV performance in heart disease, especially coronary artery disease.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Left ventricular (LV) performance evaluation is critical in various heart diseases.
- Understanding impaired LV function requires comprehensive assessment beyond single parameters.
Purpose of the Study:
- To identify the most sensitive indicators of impaired LV performance.
- To determine essential parameters for a full understanding of LV derangement in heart disease.
- To investigate LV behavior under different pathological stresses.
Main Methods:
- Quantitative one-plane cineangiocardiography in right anterior oblique (RAO) position.
- Volume and pressure measurements to derive pump and muscle performance parameters.
- Analysis of ejection fraction (EF), mean velocity of circumferential fiber shortening (VCF), and wall motion abnormalities.
Main Results:
- Mean VCF and EF were the most sensitive indicators of impaired LV performance.
- Close correlation between mean VCF and EF, with occasional discordant changes.
- Wall motion abnormalities were frequently observed in patients with coronary artery disease and cardiomyopathy.
Conclusions:
- Assessment of EF, mean VCF, and wall motion abnormalities is essential for a complete understanding of LV function in heart disease.
- This comprehensive assessment is particularly important for patients with coronary artery disease.
- LV behavior varies with pathological stresses, with specific considerations for mitral stenosis.
Abstract:
Quantitative one-plane cineangiocardiography in right anterior oblique position for evaluation of LV performance was carried out in 62 patients with various heart diseases and in 13 subjects with normal LV. Parameters for evaluating both pump and muscle performances were derived from volume and pressure measurements. Of 31 patients with either systolic hypertension or LV myocardial diseases (coronary artery disease or idiopathic cardiomyopathy), 14 had clinical evidence of LV failure before the study. It was found that mean VCF and EF were most sensitive indicators of impaired LV performance among the various parameters. There was a close correlation between mean VCF and EF, yet discordant changes of both parameters were noted in some patients. Furthermore, wall motion abnormalities were not infrequently observed in patients with coronary artery disease or primary cardiomyopathy. Therefore, assessment of at least three ejection properties (EF, mean VCF and wall motion abnormalities) are considered to be essential for full understanding of derangement of LV function in heart disease. This is especially true of patients with coronary artery disease. LV behavior in relation to different pathological stresses or lesions, such as chronic pressure or volume load, myocardial disease and mitral stenosis, was also studied and possible cause of impaired LV myocardial function in mitral stenosis was discussed.