Circulation, Vol 74, 796-804, Copyright © 1986 by American Heart Association
FH Sheehan, J Schofer, DG Mathey, MA Kellett, H Smith, EL Bolson and HT Dodge
The value of performing biplane vs single plane analysis of regional wall
motion from contrast ventriculograms was determined in 102 patients who
received thrombolytic therapy and who underwent biplane ventriculography
during acute myocardial infarction (n = 67), at follow- up more than 2
weeks later (n = 80), or both (n = 45). Hypokinesis in the infarct region
and hyperkinesis in the noninfarct region were measured by the centerline
method in the respective artery territories, which were defined from the
data of 62 patients with single-vessel disease and were expressed in units
of standard deviations from the mean of 32 normal subjects. Hypokinesis was
more severe and extended over a longer segment of the left ventricular
contour when measured in the right anterior oblique (RAO) projection in
thrombosis of the left anterior descending coronary artery (LAD) but more
severe and extensive in the left anterior oblique (LAO) projection in
circumflex stenosis. Hyperkinesis opposite the LAD or the circumflex was
greater in the LAO projection. In patients with thrombosis of the right
coronary artery, wall motion abnormalities were similar in the two
projections. Thus the evaluation of hypokinesis caused by acute coronary
thrombosis and of the effect of therapeutic interventions in salvaging
function can be adequately evaluated from single-plane 30 degree RAO
ventriculograms, except in the small minority of patients with circumflex
thrombosis.
ARTICLES
Measurement of regional wall motion from biplane contrast ventriculograms: a comparison of the 30 degree right anterior oblique and 60 degree left anterior oblique projections in patients with acute myocardial infarction
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