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(Circulation. 1968;38:838.)
© 1968 American Heart Association, Inc.

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Quantitative Angiocardiography

III. Relationships of Left Ventricular Pressure, Volume, and Mass in Aortic Valve Disease

J. WARD KENNEDY M.D.¹; R. D. TWISS M.D.¹; J. R. BLACKMON M.D.¹; H. T. DODGE M.D.¹

¹ From the Medical Service, Veterans Administration Hospital, and the Department of Medicine, University of Washington School of Medicine, Seattle, Washington.

Quantitative angiocardiographic techniques have been used to determine left ventricular volume and mass in 100 patients with isolated aortic valve disease. The patients were divided into three groups: aortic stenosis (AS), 22 patients; aortic regurgitation (AR), 38 patients; and combined stenosis and regurgitation (AS+AR), 40 patients. The distribution of left ventricular volume and mass and their relationship to standard intracardiac pressure and flow determinations are presented for each group in order to define the hemodynamic and functional characteristics of the left ventricle in these patients. Mean values for end-diastolic volumes (EDV) in the three groups were AS=85 ml/m², AS+AR=143 ml/m² and AR=197 ml/m². Mean values for ejection fraction (EF=SV/EDV) were similar in the three groups, AS=61%, AR= 55%, AS+AR=58%.

Left ventricular mass (LVM) was smaller in AS, mean=167 g/m², and similar in AR, mean=232 g/m², and AS+AR, mean=235 g/m². Left ventricular filling pressure (LVEDP) was correlated with EDV in AS, r=0.45, P<0.05, and AS+AR, r=0.51, P<0.001, but not in AR. A similar relationship was seen between LVEDP and EF. The arteriovenous oxygen difference correlated well with EF in AS, r=–0.76. P<0.001. This relationship was weaker in AS+AR, r= –0.45, P<0.01, and AR, r=–0.45, P<0.01. Correlations were also present between increased LVM and elevated LVEDP and increased LVM and decreased EF in patients with AS and AS+AR.

Key Words: Rheumatic heart disease • Ejection fraction • Left ventricular hypertrophy • Left ventricular function

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