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[Digital subtraction ventriculography in determining global and regional left ventricular parameters compared to left
Insights
Digital subtraction ventriculography (DSV) offers comparable and sometimes superior accuracy to conventional methods for assessing heart function after myocardial infarction. DSV shows higher sensitivity in detecting reduced ejection fractions and evaluating specific heart regions.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Assessing left ventricular function is crucial in patients with heart disease, particularly after myocardial infarction.
- Conventional contrast ventriculography has been the standard for evaluating cardiac structure and function.
- Advancements in digital imaging offer potential improvements in diagnostic accuracy and sensitivity.
Purpose of the Study:
- To compare the diagnostic accuracy and sensitivity of digital subtraction ventriculography (DSV) against conventional contrast ventriculography.
- To evaluate the effectiveness of DSV in assessing ejection fraction and regional wall motion abnormalities in patients with transmural myocardial infarction.
Main Methods:
- Digital subtraction ventriculography (DSV) was performed on 46 patients with a history of transmural myocardial infarction.
- Urografin 76 was administered via superior vena cava catheterization at a specific flow rate.
- Results from DSV were compared with conventional contrast ventriculograms for quantitative and qualitative assessments.
Main Results:
- A high correlation (r = 0.93, p < 0.001) was found between DSV and conventional methods for ejection fraction determination.
- DSV demonstrated greater sensitivity than conventional methods in identifying severely reduced ejection fractions.
- DSV showed comparable accuracy for anterolateral wall motion but higher sensitivity for apical abnormalities; 85.7% sensitivity for inferior region evaluation.
Conclusions:
- Digital subtraction ventriculography (DSV) is a highly accurate and sensitive imaging technique for evaluating left ventricular function post-myocardial infarction.
- DSV may serve as a viable alternative to conventional contrast ventriculography in specific clinical scenarios.
- The findings support the increased sensitivity of DSV for detecting subtle regional wall motion deficits and reduced ejection fractions.
Abstract:
Since May 1982 we studied more than 150 patients with heart diseases by means of digital angiography, out of them 46 patients with a history of transmural myocardial infarction were selected. Urografin 76, 30 ml, was administered at a flow rate of 18 ml/s by means of a catheter in the superior vena cava during digital subtraction ventriculography. Results were compared with conventional contrast ventriculograms. The correlation coefficient was r = 0.93 (p less than 0.001) for determination of ejection fraction with both methods. The data in individual cases suggest that DSV is more sensitive than conventional contrast ventriculography in determination of severely reduced ejection fractions. The methods are practically identical in qualitative evaluation of disorders of regional wall motion in the anterolateral region, while DSV is more sensitive than conventional ventriculography in evaluating the apical region. Sensitivity was 85.7% when the two methods were compared in evaluation of the inferior region of the left ventricle. Both methods are identical in demonstration of severely deformed ventricles. Digital subtraction ventriculography may replace conventional contrast ventriculography in some of the situations discussed above.