Evaluation of the left ventricular performance in patients with ischemic heart disease using radionuclide angiocardiography.

Radionuclide angiocardiography was utilized for the measurement of left ventricular dynamics and the analysis of its segmental wall motion. Left ventricular performance was measured by the first pass method and gated equilibrium method in patients with ischemic heart disease. The left ventricular wall motion was also examined by the analysis of computer-drawn outlines of radioactivity counts of the left ventricular chamber. These measurements were well correlated with those obtained by invasive methods such as contrast cine-ventriculography and thermodilution method in the resting state. The patients with effort angina often showed an almost normal left ventricular performance and wall motion in the resting state without ischemic episodes. However, at the time when anginal attack was provoked with exercise testing, an asynergy and a reduced performance of left ventricle were observed. The extent and localization of this asynergy well corresponded with the defect of myocardial scintigrams determined by 201-Tl stress myocardial imaging. From above findings we conclude that the myocardial ischemia with asynergy is a cause of decreased left ventricular hemodynamics during anginal attack. Although further evaluation is necessary to know limitations and to avoid inaccuracy, these techniques were shown to have a significant usefullness in evaluating ischemic heart disease.