Left ventricular aneurysm. A radiographic method for quantitative angiocardiography with reconstruction of ventricular geometry.

A method is presented for the measurement of ventricular aneurysms (An) by which the ventricle is considered to be composed of an ellipsoid or contracting portion and a hemispheroid or aneurysmal portion. Validation of the method with radio-opaque plastic models gave a difference between true and calculated volume measurements of not more than +/- 5%. In one hundred patients with aneurysms of different size and location the absolute volume of the aneurysm and its percentage of total left ventricular volume (V An %) were measured, and the statistical correlation with several hemodynamic and angiographic parameters was studied. Cardiac index (CI) and stroke volume (SV) appeared to decrease with increasing V An %, but with a correlation of no statistical significance. Left ventricular end-diastolic pressure (LVEDP) is raised with increasing V An %, but with a low statistical significance. Of angiographic parameters, end-diastolic volume (EDV) increased progressively and significantly with increasing V An %. This result is related to the extension of the noncontracting segment. Global ejection fraction (EF) decreased progressively with increasing enlargement of the aneurysm, in a statistically high correlation, and seemed to be the most sensitive index of total ventricular performance. Ejection fraction of the contractile portion (EFcp) was not related to V An % as involvement of large ventricular areas was consistent with preservation of contraction in unaffected regions. Evaluation of this parameter is suggested as a method of assessment for surgical treatment.