A comparison of conventional contrast ventriculography and digital subtraction ventriculography

We studied 46 patients with a history of transmural myocardial infarction or angiographic evidence of coronary artery stenosis with both conventional contrast ventriculography and digital subtraction ventriculography from May to September 1982. 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 (DSV). Results of the latter were compared with conventional contrast ventriculograms. The correlation coefficient was r =0.938 (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.