An Angiocardiographic Analysis of the Thickness of the Left Ventricular Wall and Cavity in Aortic Stenosis and Other Valvular Lesions

In order to provide information concerning changes in the width of the left ventricular cavity and the thickness of the left ventricular wall in patients with various forms of heart disease, relatively simple measurements were carried out on angiocardiograms exposed during diastole in the frontal projection. The diameter of the left ventricular cavity and the thickness of the free wall of the left ventricle were measured in a standardized manner in 57 patients, in all of whom the diagnosis had been established. In patients with valvular or discrete subvalvular aortic stenosis, the thickness of the free wall of the left ventricle was usually greater than in patients without abnormalities of the left ventricle, and the degree of thickening correlated closely with the degree of obstruction. This type of correlation was not present in patients with hypertrophic subaortic stenosis. No increase in the width of the left ventricular cavity was noted in patients with obstruction to left ventricular outflow. In patients with aortic or mitral regurgitation, the width of the left ventricular cavity tended to be increased without any consistent increase in the thickness of the left ventricular wall. The measurements described are simple enough to be applied routinely in order to provide information concerning the effects of various forms of heart disease on the gross structure of the left ventricle during life.