Echoventriculography -- a simultaneous analysis of two-dimensional echocardiography and cineventriculography.

Abstract

SUMMARY Two-dimensional echocardiography underestimates left ventricular volume compared with cineventriculography. To exclude the influence of difference in heart rate, blood pressure, respiration phases and any effect of the contrast material on left ventricular function, simultaneous studies of twodimensional echocardiography and cineventriculography-echoventriculography were performed in 46 patients. Apical two-dimensional echocardiograms in the right anterior oblique (RAO) equivalent view were recorded before and during cineventriculography in the 300 RAO projection. End-diastolic and end-systolic volumes (EDV and ESV) were calculated using a disc method with a semiautomatic computer system. The echo transducer position relative to the left ventricular apex and long axis was analyzed. For EDV determined by two-dimensional echocardiography and cineventriculography, the linear regression equation was radiologic methods.'4 Thus, patient-related problems could explain the systematic underestimation of left ventricular volume as determined by two-dimensional echocardiography. Differences in heart rate, blood pressure and respiration, and possible influences of contrast agents have been reported.4In this study we analyzed left ventricular volumes and ejection fractions from simultaneous recordings of two-dimensional echocardiograms in the apical right anterior oblique (RAO) equivalent view and cineventriculograms in the RAO plane, eliminating any perturbing influences on left ventricular volume. Methods PatientsThe study was performed in 46 patients, 39 males and seven females, who were undergoing catheterization for evaluation of clinically suspected coronary artery disease (table 1). The mean age (± SEM) was 51.2 + 6.9 years. Thirty-seven patients had significant coronary artery disease, nine showed features of primary congestive cardiomyopathy, two had arterial hypertension, four mitral regurgitation, one patient had mitral valve prolapse, one obstructive cardiomyopathy, and one aortic insufficiency. Three patients appeared to be normal. Fifteen of the 37 patients with coronary artery disease showed asynergy of the anterior wall and 13 asynergy of the posterior wall. CatheterizationThe left ventricle was catheterized retrogradely through a percutaneous puncture of the right femoral artery. The patients were fasting and not premedicat-

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