Digital subtraction intravenous left ventricular angiography: comparison with conventional intraventricular angiography.

Standard contrast left ventriculography with catheter placement into the left ventricle entails risks and inconvenience. Computer-based digital subtraction techniques now permit high contrast left ventriculography after intravenous administration of contrast medium. To compare the accuracy of intravenous digital subtraction left ventriculography with film-based, standard contrast ventriculography, we assessed left ventricular function by both methods in 32 patients (8 with valvular disease, 22 with coronary disease and 2 with atypical pain). Studies in 31 of 32 patients were considered. Left ventricular ejection fraction by standard contrast ventriculography ranged from 24 to 88%. Digital subtraction angiography was performed with bolus injection of radiopaque contrast material (30 cc at 20 cc/s) into the inferior vena cava. The two methods correlated closely in end-diastolic volume (correlation coefficient [r] = 0.96, probability [p] less than 0.001), end-systolic volume (r = 0.97, p less than 0.001) and ejection fraction (r = 0.98, p less than 0.001). Segmental function was assessed visually; precise agreement existed between the two techniques in 123 (79%) of the 155 segments (p less than 0.001). It is concluded that intravenous digital angiography provides left ventricular images of sufficiently good quality to allow accurate quantitative assessment of global left ventricular function and volumes as well as determination of regional function.