Quantitative cardiac-cineangiography in acquired valvular heart disease

Han, M C; Lim, T H

Abstract

For the determination of the prognosis of the acquired valvular heart disease, many diagnostic tools such as,echocardiogram, computerized RI cardiac scan, cardiac cathetrization and cardiac angiography are now widely used.Among these, the cineangiography offers the most accurate and objective values in quantiation of the leftventricular performance, which is thought to be an essential prognostic factor of the valvular heart disease.Although many authors differ their opinions, increased end diastolic volume is generally understood in two ways;The one as an indicator of compensatory mechanism for the chaned hemodynamics of the heart and the other as aparameter of deteriorated left ventricular performance. Authors anayzed EDV, ESV, EF, EDP and angiographic gradeof regurgitation in 97 cases of the acquired valvular heart disease and resuls are as follows. 1. Mean EDVs are 226.2ml/m2 in AI + MI*, 167.2 ml/m2 in AI, 155,6 ml/m2 in MI* and 98.3 ml/m2 in MS respectively. 2. Means ESVs are 101.1 ml/m2 in AI +MI*, 84.1 ml/m2 in AI, 66.5 ml/m2 in MI* and 46.4 ml/m2 in MS respectively. 3. Mean EFs are 0.56in AI + MI*, 0.55 in AI, 0.57 in MI* and 0.54 in MS respectively. 4. There are higher correlations between ESV andEF than between EDV and EF. 5. There are no significant correlations bewteen EDP and EFV in all diseases entitiesexcept AI, in which large EDV relatively corrlates with high EDP. 6. In AI, EDV, ESV, EF, and angiographic gradeof regurgitation show close correlations between each other. 7. In MI with higher grade of regurgitation, ESVseems to be more sensitive indicator of left ventricular performance than EF. In MI with lower grade ofregurgitation, ER seems to be more sensitive indicator of left ventricular performance than ESV. 8. In AI + MI*,EDV, ESV and EDP show higher values than in any other diseases involving single valve aglone, but there are nocorrclations between ventricular volumes and grades of regurgitations. 9. In MS, changes in left ventricularvolumes are minimal or absent, in contrast, EFs are deteriorated as in other diseases.