Document Detail


Defining left ventricular segmental and global function by echocardiographic intraventricular contrast flow patterns.
MedLine Citation:
PMID:  11078239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Contrast echocardiography improves left ventricular (LV) endocardial border delineation by enhancement of the blood-tissue interface. In particular, the contrast appearing within the LV chamber exhibits characteristic flow patterns over the cardiac cycle, which may be related to the surrounding myocardial wall motion. To determine the relation between the LV intracavitary contrast flow pattern and surrounding wall motion, we reviewed the contrast-enhanced images of 348 consecutive patients studied at rest. We defined 2 different patterns of intracavitary contrast flow as visualized from apical views: a swift, vertical, and homogeneous flow towards the apex (pattern A), and a distinctly protracted, swirling, and heterogeneous flow (pattern B). Images recorded on videotapes were reviewed and the type of pattern (A or B) was determined within the initial 30 to 45 seconds of contrast appearance in the left ventricle. Contrast flow patterns interpreted by independent reviewer were then compared with the interpretation of the LV segmental and global function in each patient. Results demonstrate that 224 of 245 (91%) patients exhibiting pattern A had normal LV segmental function. Furthermore, all but 1 patient (102 of 103) with pattern B had > or =1 wall motion abnormality (p <0.0001). Contrast flow pattern B was observed irrespective of the location of LV wall motion abnormality. Global LV function was normal in 93% of patients exhibiting pattern A, whereas varying degrees of LV dysfunction were noted in 83% of patients with pattern B (p <0.0001). The presence of mitral regurgitation (p = 0.46), aortic insufficiency (p = 0.066), or mitral inflow Doppler abnormality (p = 0.102) was not significantly associated with either pattern. Thus, during contrast echocardiography, the LV intracavitary contrast flow pattern complements the assessment of global and segmental LV function.
Authors:
S Thanigaraj; R Chugh; K B Schechtman; L V Lee; R L Wade; J E Pérez
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The American journal of cardiology     Volume:  85     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-11-30     Completed Date:  2000-11-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  65-8     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA. hari@cardsfellow.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aortic Valve Insufficiency / complications*
Chi-Square Distribution
Contrast Media*
Echocardiography / instrumentation,  methods*
Echocardiography, Doppler / instrumentation,  methods*
Hemorheology*
Humans
Image Enhancement / methods*
Logistic Models
Mitral Valve Insufficiency / complications*
Observer Variation
Predictive Value of Tests
Severity of Illness Index
Ventricular Dysfunction, Left / etiology,  physiopathology*,  ultrasonography*
Ventricular Function, Left*
Videotape Recording
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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