Effect of an anterior wall motion abnormality on the results of single-plane and biplane left ventriculography.
Although the biplane area-length method would be optimal for all left ventriculograms, 2 contrast injections are needed in laboratories with single-plane imaging equipment. The purpose of this study was to develop practical guidelines to identify the need for biplane left ventriculography in laboratories with single-plane equipment. From a retrospective analysis of 91 consecutive biplane ventriculograms (group 1), guidelines were identified that predicted when the ejection fraction calculated by the biplane method would differ significantly from the single-plane value. These guidelines were derived from information immediately available to the operator in the laboratory at the time of the procedure. Patients in group 1 were divided into 3 subgroups: biplane exceeding single-plane ejection fraction by greater than or equal to 0.05 (n = 20); single-plane exceeding biplane ejection fraction by greater than or equal to 0.05 (n = 14); and ejection fractions within +/- 0.04 by the 2 methods (n = 57). By multivariate analysis, the only predictor of a higher ejection fraction calculated by the biplane method was an anterior wall motion abnormality. This finding was tested prospectively in a separate group of 60 patients (group 2). Left ventriculograms in group 2 patients were stratified before analysis by the presence or absence of an anterior wall motion abnormality. In patients with anterior wall motion abnormalities, the biplane ejection fraction was greater than the single-plane value by 0.05 +/- 0.04 (range -0.03 to +0.15). In contrast, this difference in patients without anterior wall motion abnormalities was -0.01 +/- 0.04 (range -0.09 to +0.06; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Tate
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C.V. Richardson Cardiac Catheterization Laboratory, University of North Carolina Hospitals, Chapel Hill 27514.
Weaver
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Dehmer
G J
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D006328:Cardiac Catheterization; D002932:Cineangiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009200:Myocardial Contraction / Q000502:physiology; D011237:Predictive Value of Tests; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*