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[Left ventricular kinetics studied by the color kinesis method. Comparison of bidimensional echographic and
E Vermes1, P Guyon, M Weingrod
1Service cardiologie et urgences cardiovasculaires, CHG, Saint-Germain-en-Laye.
Insights
Colour kinesis (CK) significantly improves left ventricular wall motion assessment compared to two-dimensional echocardiography (2DE). CK offers greater precision and reduced observer variability in evaluating coronary patient heart function.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Left ventricular wall motion analysis is crucial for diagnosing and managing coronary artery disease.
- Two-dimensional echocardiography (2DE) is a standard imaging modality, but its accuracy in assessing wall motion can be limited.
- Left ventriculography serves as the reference standard but is invasive.
Purpose of the Study:
- To evaluate the diagnostic value of Colour Kinesis (CK) in assessing left ventricular (LV) wall motion.
- To compare the efficacy of CK against 2DE and left ventriculography in coronary patients.
- To determine the impact of CK on inter-observer variability.
Main Methods:
- A study involving 15 coronary patients (8 post-myocardial infarction, 7 post-unstable angina).
- LV wall motion assessed using 2DE and CK, with left ventriculography as the reference.
- Left ventricle divided into 7 segments for analysis, excluding segments not visualized on angiography.
Main Results:
- CK correctly evaluated 80% of LV segments, significantly outperforming 2DE (68%, p < 0.05).
- CK improved assessment across most segments, except the interventricular septum.
- CK reduced inter-observer variability (kappa=0.7) compared to 2DE (kappa=0.57).
Conclusions:
- Colour Kinesis (CK) is a more precise method for evaluating left ventricular wall motion than 2DE.
- CK demonstrates reduced inter-observer variability, enhancing diagnostic reliability.
- CK shows significant potential for improving echocardiographic assessment in patients with coronary artery disease.
Abstract:
The object of this study was to assess the value of CK in the evaluation of left ventricular wall motion. Fifteen coronary patients aged 56 +/- 12 years were included: 8 patients were examined after acute myocardial infarction and 7 after unstable angina with a history of myocardial information. The left ventricle was divided into 7 segments after a modified Heger model, excluding the basal septal and basal lateral segments not seen on angiography. The left ventricular wall motion was assessed in two-dimensional echocardiography (2DE) and colour kinesis (CK) by two observers and compared with the results of left ventriculography, considered the reference method. Over all the 105 segments studied (7 segments for each of the 15 patients), CK was significantly better than 2DE (80% of segments correctly evaluated by CK vs 68% by 2DE, p < 0.05). Colour kinesis significantly improved the study of all segments except the interventricular septum (67% vs 60%, p = NS). The inter-observer variability in 2DE and CK evaluated over 135 segments (9 per patient) by the kappa was improved by colour kinesis (0.57 in 2DE, 0.7 in CK). The authors conclude that CK enables evaluation of left ventricular wall motion with greater precision and less inter-observer variability.