Usefulness and limitations of circumferential fibre shortening velocity in evaluating segmental disorders of left ventricular contraction.

In order to study the possibility of using circumferential fibre shortening velocity (VCF) to assess regional left ventricular performance, 2I left ventricular angiograms (single-plane cine) from i9 patients were ex- amined. In 8 patients with normal left ventricle, measurements of instantaneous and mean VcF in 4 equidistant chords revealed uniform velocities at all chords. In 7 patients with coronary artery disease mean and max VCF were depressed in the areas involved by asynergy; however, when only one wall was affected, velocity measurements of the hemichords provided a better definition of regional performance. VCF at the base (chords A and B) was normal in 2 out of 3 patients with apical asynergy, and augmented in one. Angiotensin produced a reduction in the mean velocity of the anterior wall in a patient with inferior dyskinesis-akinesis; in con- trast, nitroglycerin was associated with augmented velocity of the non-akinetic segment in a second patient with inferior akinesis and anteroapical hypokinesis.