Does left ventriculographic classification correlate with prognosis in patients with primary myocardial disease?
Left ventriculography can classify primary myocardial disease into distinct hemodynamic and structural types that correlate with short-term prognosis.
Thirty-four patients with primary myocardial disease were studied and classified into three distinct types based on their left ventriculogram. Each had unique ventriculographic characteristics and findings. Type I are patients with a normal contraction pattern and an elevated left ventricular end-diastolic pressure. Type II A are patients with a hypertrophic pattern without obstruction to outflow while type II B patients have outflow obstruction. Type III A are patients with generalized hypokinesis. Type III B have a similar contraction pattern but in addition show asynergy. Analysis of the right ventriculogram in seven patients showed changes paralleling those seen in the left ventricle, including asynergic patterns of contraction. The electrocardiogram and chest roentgenogram were found to be sensitive but nonspecific indicators of disease. The short-term prognosis was excellent with type I and poor with type III while type II patients had an intermediate prognosis.
Kreulen et al. (1973) studied this question.