Quantitative analysis of segmental wall motion throughout systole and diastole in the normal human left ventricle

We traced left ventricular contours, frame-by-frame throughout systole and diastole, of normal sinus beats from 30 degrees right anterior oblique ventriculograms from 32 normal patients. We separated both systole and diastole into 19 equal time intervals each and calculated regional lengths (R), normalized by both end-diastole length and relative time interval (T) in systole and diastole and diastole, for the middle inferior wall, distal inferior wall, apex, distal anterior wall, middle anterior wall, and proximal anterior wall. We also computed the relative velocities of R, delta R/ delta T, over each quarter of systole and diastole. Comparing systole with diastole, we found significant differences between paired values of R at all regions except the distal inferior wall, but these differences were not the same between regions. Between regions, mean R and delta R/ delta T values were significantly different as early as the first quarter of systole. Within a region, there were significant differences between mean R and delta R/ delta T values over intervals as short as one-fourth of systole or diastole. Thus, there is no homogeneity between regions in normal wall motion in both systole and diastole. This normal lack of homogeneity has important clinical implications for identifying abnormal wall motion in individual patients from ventriculographic measurements, and for using the information present in the diastole portion of the ventriculogram to characterize normal segmental function.