Regional left ventricular wall motion abnormalities in chronic volume overload

Computer-assisted analysis of left ventricular (LV) wall motion has been performed in 12 patients (pts) with chronic volume overload and in seven normal subjects. All pts were in sinus rhythm, without congestive heart failure and without coronary artery disease at selective coronary angiography; 30 degrees right anterior oblique ventriculograms were employed in each case. Thirty-six radiants were automatically traced and the percent shortening of each radiant was calculated using two different reference methods (fix and floating methods). In valvular heart disease (VHD) pts LV volumes were significantly increased, and ejection fraction and LV eccentricity were significantly reduced. LV eccentricity inversely correlated with LV volumes. VHD pts showed regional LV abnormalities. Inferoapical and anterior wall motion was significantly reduced (two-sample t-test P less than 0.05) using the fix method. With this method a significant inverse correlation between percent shortening of the radiants correspondent to the inferoapical region and end-diastolic and end-systolic volumes was found; a significant direct correlation was found with LV systolic eccentricity. Ejection fraction directly correlated with the percent shortening of radiants correspondent to both the anterior and inferior regions. The role of LV "dynamic geometry" alterations as a possible cause for the observed regional LV wall motion abnormalities is emphasized.