SUMMARY We traced left ventricular contours, frame-by-frame throughout systole and diastole, of normal sinus beats from 300 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-diastolic length and relative time interval (T) in systole 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, AR/AT, 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 AR/AT values were significantly different as early as tde first quarter of systole. Within a region, there were significant differences between mean R and AR/AT 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 diastolic portion of the ventriculogram to characterize normal and abnormal segmental function.QUANTITATIVE ANALYSIS of left ventricular segmental wall motion has become an important tool for evaluating the ventricular function of patients with ischemic heart disease.'1-7 Despite the widespread application of quantitative techniques to characterize localized abnormalities of contraction, there have been relatively few detailed studies of regional differences in normal contraction.1' 7 10, 17-19 Further, there are few data available about normal patterns of segmental wall motion during diastole20 22 or the normal relationships between systolic and diastolic motion in the same region.22In this study, we measured segmental wall motion throughout systole and diastole in 32 patients who were catheterized for evaluation of chest discomfort syndromes and found to have normal cardiac function and no significant coronary artery disease. We quantified regional patterns of normal wall motion throughout the cardiac cycle, examined relationships between systolic and diastolic motion in each region, and compared patterns both between regions at the same points in the cardiac cycle and between points in the cardiac cycle at the same region. Methods Patient PopulationWe used ventriculograms obtained in 13 men and 19 women, average age 52 ± 10 years (mean ± SD), who Thirty-degree right anterior oblique (RAO) left ventriculograms were recorded at 60 frames/sec on 16-mm cine film as meglumine diatrizoate (Renografin-76) was injected into the ventricle at a rate of 15 ml/sec for 3 seconds. We reviewed each ventriculogram and only analyzed sinus beats that were not preceded by...
SUMMARY We evaluated changes in ventricular wall motion after surgery by comparing smoothed, filtered measurements of regional percent shortening (RPS) from right anterior oblique ventriculograms in 37 patients before and after surgery. After surgery there was a significant (p < 0.05) decrease in the number of regions with hypokinetic wall motion. The distribution of RPS values was also different (p < 0.005). However, the mean value of RPS for the surgery group as a whole was not significantly altered. These data were contrasted with RPS data from 11 control patients, who were each studied twice but did not have surgical intervention. Similar analysis of the control group did not show any significant change between studies in the number of hypokinetic regions, and the distributions of RPS for the first and second angiograms were not different. We found a 10.3% absolute mean change in repeated measurements of RPS in the control group. We conclude that significant changes occurred after surgery that were not evident in the control group, and the amount of variability in repeated measurements of RPS suggests that analysis should be applied to group rather than individual data.
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