Clinical assessment of left ventricular regional contraction patterns and ejection fraction by high-resolution gated...

An improved, noninvasive, radionuclidic, gated blood-pool imaging technique has been developed for clinical analysis of regional contraction abnormalities of the left ventricle and determination of ejection fraction. The principal innovations include high-resolution collimation, higher information density, improved method for dynamic aortic-mitral-diaphragmatic border delineation, accurate selection of the endsystolic gating interval through the use of the phonocardiogram, and accurate end-diastole by on-line gating immediately following the electrocardiographic QRS. The results of scintigraphic studies were compared with selective radiopaque cineangiographic findings in 27 patients with cardiac disease; excellent correlations of ejection fractions (r = 0.93) and abnormal contraction patterns (17/17 patients) were demonstrated. In addition, the clinical usefulness in evaluating ventricular performance was demonstrated in 79 patients with acute and chronic coronary artery disease. This radionuclidic technique allowed assessment of reversibility of segmental dyssynergy by the response to nitroglycerin in 20 patients. These findings demonstrate the validity of this improved radionuclidic technique in the atraumatic quantification of ventricular function and suggest its usefulness in a variety of clinical conditions.