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Relationship of angiographic and echographic dimensions in chronic left ventricular dilatation
Insights
Echocardiography (Echo) measurements of left ventricular (LV) diameter show discrepancies compared to angiocardiography (Angio) in patients with valvular regurgitation. Excluding these patients improves the correlation between Echo and Angio ejection fraction (EF) measurements.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Angiocardiography
Background:
- Discrepancies exist between echocardiographic (Echo) % delta Diameter and angiocardiographic (Angio) ejection fraction (EF).
- These discrepancies are particularly noted in patients with valvular regurgitation.
- Left ventricular (LV) dilatation is a key factor influencing measurement accuracy.
Purpose of the Study:
- To investigate the discrepancies between Echo % delta D and Angio EF.
- To evaluate the impact of valvular disease on these measurements.
- To determine the correlation between Echo and Angio measurements in various cardiac conditions.
Main Methods:
- Studied 112 patients with varying degrees of LV dilatation using M-mode Echo.
- Patients included normals, primary myocardial disease, and mitral/aortic regurgitation groups.
- Compared Echo end-diastolic diameter (EDD) and end-systolic diameter (ESD) with Angio-derived values.
Main Results:
- Echo EDD and ESD were consistently smaller than Angio values, with magnified differences at larger EDDs (p < 0.01).
- Correlation between Echo % delta D and Angio EF was relatively poor (r = 0.69).
- Excluding valvular disease patients improved the correlation to r = 0.82, while Angio % delta D and EF correlated highly (r = 0.98).
Conclusions:
- Disparities in Echo and Angio EF measurements are influenced by increased ventricular sphericity with dilation.
- Measurement errors in Echo for EDD and ESD differ in valvular disease, affecting EF correlation.
- Angiocardiography provides a more reliable EF assessment, especially in the presence of valvular regurgitation.
Abstract:
Recently discrepancies have been reported between echocardiographic (Echo) % delta D and angiocardiographic (Angio) ejection fraction (EF), particularly in valvular regurgitation. One hundred and twelve patients with varying degrees of LV dilatation were studied in the right anterior oblique position with M-mode Echo. None had localized contraction abnormalities. There were 20 normals, 33 with primary myocardial disease, and 59 with mitral and/or aortic regurgitation. Echo end-diastolic diameter (EDD) and end-systolic diameter (ESD) were consistently smaller than Angio calculated EDD and ESD, and the difference was magnified at larger EDDs (p less than 0.01). The result is a relatively poor correlation of Echo % delta D and Angio EF (r = 0.69), compared to r = 0.98 for Angio % delta D and EF, both from Angio visualization. However, if valvular disease patients are excluded, the correlation improves to 0.82. The mechanisms for these disparities include increased sphericity as the ventricle dilates, and in the case of valvular disease where the EF is better for any degree of dilatation, the echo measurement errors for EDD and ESD are different.