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(Circulation. 1973;47:299.)
© 1973 American Heart Association, Inc.

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Ventriculographic Patterns and Hemodynamics in Primary Myocardial Disease

THOMAS H. KREULEN M.D.¹; RICHARD GORLIN M.D.¹; MICHAEL V. HERMAN M.D.¹

¹ From the Cardiovascular Division, Department of Medicine, Peter Bent Brigham Hospital and Harvard Medical School, Boston, Massachusetts.

Thirty-four patients with primary myocardial disease were studied and classified into three distinct types based on their left ventriculogram. Each had unique ventriculographic characteristics and findings. Type I are patients with a normal contraction pattern and an elevated left ventricular end-diastolic pressure. Type II A are patients with a hypertrophic pattern without obstruction to outflow while type II B patients have outflow obstruction. Type III A are patients with generalized hypokinesis. Type III B have a similar contraction pattern but in addition show asynergy. Analysis of the right ventriculogram in seven patients showed changes paralleling those seen in the left ventricle, including asynergic patterns of contraction. The electrocardiogram and chest roentgenogram were found to be sensitive but nonspecific indicators of disease. The short-term prognosis was excellent with type I and poor with type III while type II patients had an intermediate prognosis.

Key Words: Hypertrophy • Congestive heart failure • Left ventricular mass • Right ventricle • Asynergy

Submitted on June 26, 1972
Accepted on October 2, 1972