Measurements of Left Ventricular Volume in Man by Cineangiocardiography

The use of cineangiocardiography has brought a remarkable progress in the study of myocardial function as well as diagnosis of heart disease. This study is to measure left ventricular volume by one-plane cineangiocardiography, and to apply this method to (1) measurement of regurgitation and left-to-right shunt, (2) measurement of left ventricular work by making a pressure-volume curve, and (3) investigation of left ventricular function in health and disease by comparing left ventricular volume with the hemodynamics of the left ventricle. Material and Method: Twenty patients, 9 to 48 years in age and male in 10 and female in 10, underwent the examina-tion, who consisted of 7 cases with innocent cardiac murmur, 5 with mitral incompetence, 4 with primary myocardial disease, and 4 with miscellaneous heart diseases. The examination was made with only local anesthesia in supine position in the fasting state. After the right heart catheterization through the saphenous vein, the transseptal left atrial puncture was made by a Brockenbrough catheter, and then the tip of the catheter was advanced into the left ventricle to measure left ventricular pressure during cinematographing. A Ducor catheter was put in the left ventricle through a femoral artery for the left ventricular cineangiocardiography. The angiography was made in the right anterior oblique position and the anteroposterior position. During the cinematization left ventricular pressure, electrocardiogram, the injection sound of contrast media and neon-maker were recorded in a polygram. The neon-marker flashed at 2 cycles per sec and was pictured simultaneously in both the cinefilm and the polygram. Cardiac output was measured by the dye method using a cuvette. The volume (V) of the left ventricle was calculated by V = πLM2/6f3 using one-plane cineangiogram on the assumption that the left ventricle is a revolving ellipsoid, where L is the longest axis of the ventricle, M is short axis intersecting at right angles at a midpoint of L and f is a co-efficient for the correction of magnification rate by X-ray beam and its distortion. The rate of regurgitation or shunt was calculated as follows, the rate = (left ventricular output by cineangio-cardiography - forward cardiac output by dye method) × 100/(forward cardiac output by dye method). Systolic, diastolic and net cardiac words were calculated from a pressure-volume diagram in one cardiac cycle.