Circulation, Vol 68, 550-559, Copyright © 1983 by American Heart Association
FH Sheehan, DK Stewart, HT Dodge, S Mitten, EL Bolson and BG Brown
Four types of variability affecting quantification of regional wall motion
from contrast left ventriculograms (LVgrams) were studied. These included
beat-to-beat variability in 24 LVgrams, intraobserver and interobserver
variability in 20 LVgrams, and study-to-study variability in serial LVgrams
of 21 patients with stable coronary artery disease. Motion was measured at
100 equidistant chords perpendicular to a center line drawn midway between
the end-diastolic and end-systolic contours and normalized for heart size.
Variability was computed as the absolute difference between observations.
Beat-to-beat, intraobserver, and interobserver variability at the 100
chords were similar, averaging 14%, 14%, and 17%, respectively, of the mean
motion in 64 patients with normal ventriculograms. Study-to-study
variability was significantly higher, averaging 30% of mean normal motion,
but was reduced when regional motion was calculated as the mean motion of
chords within a region of interest. Variability peaked at the apex.
Realignment to correct for cardiac rotation significantly increased
variability. Investigators whose methods of wall motion analysis rely on
identification of the apex as a landmark should be aware of this source of
potential variability and error.
ARTICLES
Variability in the measurement of regional left ventricular wall motion from contrast angiograms
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