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The multicentric character of normal left ventricular wall motion. Implications for the evaluation of regional wall
Insights
Current methods for assessing ventricular wall motion may be inaccurate. This study suggests the specific heart wall region should determine the measurement center for improved accuracy in diagnosing abnormalities.
Area of Science:
- Cardiology
- Medical Imaging
- Biomechanical Engineering
Background:
- Radiologic assessment of regional ventricular wall motion commonly uses rectilinear hemiaxes or radial chords.
- These methods rely on assumptions about wall segment movement relative to the ventricular long axis or a common center.
Purpose of the Study:
- To evaluate the validity of current assumptions in regional ventricular wall motion analysis.
- To determine if a more accurate method for measuring wall motion abnormalities exists.
Main Methods:
- Analysis of 17 normal right anterior oblique ventriculograms (end-systolic and end-diastolic frames).
- Digitizer and computer analysis of 47 perimeter points per ventriculogram to define motion vectors.
- Development of computer models for abnormal regional wall motion using varying center points.
Main Results:
- Identified three average centers that could represent six regions of the normal angiographic silhouette.
- Computer models revealed significant discrepancies between chord, hemiaxis, and rectilinear area methods, especially in apical and basal regions.
- Discrepancies highlight limitations of current standardized measurement approaches.
Conclusions:
- Current methods for assessing regional ventricular wall motion may not be universally applicable.
- The specific region of the ventricular wall influences the optimal center for measuring motion abnormalities.
- Future assessments should consider region-specific centers for improved diagnostic accuracy.
Abstract:
Current radiologic approaches to evaluation of regional ventricular wall motion generally employ rectilinear hemichords ("hemiaxes") or radial hemichords ("chords"), defined by the presumptions that wall segments move either perpendicularly toward the ventricular long axis, or toward some common center, respectively. In order to test these presumptions, the end-systolic and end-diastolic frames of 17 normal right anterior oblique (left) ventriculograms were analyzed, using a digitizer and a computer. The motion vectors of 47 points on each ventriculographic perimeter were defined by centers (located along the ventricular long axis). Twenty average centers were found which could be represented by three centers, for six regions of the normal angiographic silhouette. Computer models of abnormal regional wall motion, using three centers, disclosed appreciable discrepancies among the chord, hemiaxis and rectilinear area methods, particularly for the apical and basal wall regions. The model data suggest that the wall region, itself, dictates the center which should be used for measuring an abnormality of regional wall motion.