Abstract
To determine the variation in the repeated evaluation of quantitative regional wall motion of the left ventricle (LV) from right anterior oblique (RAO) silhouettes, an intra- and inter-observer test was performed in 17 patients without wall motion abnormalities, using nine different methods of regional wall motion (RWM) analysis. The results were:
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1.
Around the cardiac apex and near the valve plane there are regions where the subjective contour delineation yields regional mean discrepancies up to 4–5 mm (2–3 mm, respectively, near the valves); while in the other regions the mean discrepancies are usually smaller than 1 mm.
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2.
Absolute regional contour discrepancies, calculated in mm, show only small differences in the various methods applied for RWM analysis.
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3.
If these discrepancies instead are calculated as relative changes (in relative percent) of hemiaxial or segmental shortening or area diminution, the method applied is of great significance, since the length of the axes can vary considerably from method to method.
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4.
From all methods applied for RWM analysis, that of Mathes [10] (radial method) had the smallest average discrepancy.
These results suggest, that the LV silhouette may be best defined in the anterior and inferior wall area, while in other regions subjective impressions of contour tracing may produce a considerable variation, which can be further enhanced by the method applied for RWM analysis. Methods that employ relatively large axes of as similar as possible length are therefore preferred.
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References
Chaitman BR, Demots H, Bristow JD, Rösch J, Rahimtoola SH (1975) Objective and subjective analysis of left ventricular angiograms. Circulation 52:420–425
Zir LM, Miller SW, Dinsmore RE, Gilbert JP, Harthorne JW (1976) Interobserver variability in coronary angiography. Circulation 53:627–632
Herman MV, Heinle RA, Klein MD, Gorlin R (1967) Localized disorders in myocardial contraction. N Engl J Med 277:222–231
Hamilton GW, Murray JA, Kennedy JW (1972) Quantitative angiocardiography in ischemic heart disease. Circulation 45:1065–1080
Chatterjee K, Swan HJC, Parmley WW, Sustaita H, Marcus H, Matloff J (1972) Depression of left ventricular function due to acute myocardial ischemia and its reversal following aortocoronary saphenous vein bypass. N Engl J Med 286:117–1122
Sniderman AD, Marpole D, Fallen EL (1973) Regional contraction patterns in the normal and ischemic left ventricle in man. Am J Cardiol 31:484–489
Harris LD, Clayton PD, Marshall HW, Warner HR (1974) A technique for the detection of asynergistic motion in the left ventricle. Comput Biomed Res 7:380–394
Leighton RF, Wilt SM, Lewis RP (1974) Detection of hypokinesis by a quantitative analysis of left ventricular cineangiograms. Circulation 50:121–127
Simon R, Amende I, Lichtlen P (1979) Das linksventrikuläre Angiogram. In: Lichtlen PR (ed) Koronarangiographie. Perimed Verlag, Erlangen, pp 249–291
Mathes P, Delius W, Sebening H, Wirtzfeld A, Blömer H (1976) Das regionale Kontraktionsverhalten der linken Herzkammer bei kongestiver Kardiomyopathie. Dtsch Med Wochenschr 101:995–999
Hood WP, Smith LR, Amende I, Simon R, Lichtlen PR (1977) Application of a computerized system for analysis of regional left ventricular function. In: Computers in cardiology 1977, IEEE Comput Soc, Long Beach, CA, pp 359–361
Rickards A, Seabra-Gomes R, Thurston P (1977) The assessment of regional abnormalities of the left ventricle by angiography. Eur J Cardiol 5:167–182
Pachinger O (1978) Quantitative Erfassung regionaler Störungen der Myokardfunktion bei der koronaren Herzerkrankung. Wien Klin Wochenschr (Suppl 85) 90:1–34
Sigel H, Nechwatal W, Stauch M (1981) Zur Frage der Reproduzierbarkeit von Parametern der quantitativen globalen und regionalen Lävangiografie im intra- und interindividuellen Observer-Vergleich. Z Kardiol 70:742–747
Gelberg HJ, Brundage BH, Glantz S, Parmley WW (1979) Quantitative left ventricular wall motion analysis: A comparison of area, chord and radial methods. Circulation 59:991–1000
Ingels NB, Daughters GT, Stinson EB, Alderman EL (1980) Evaluation of methods for quantitating left ventricular segmental wall motion in man using myocardial markers as a standard. Circulation 61:966–972
Karsch KR, Lamm U, Blanke H, Rentrop KP (1980) Comparison of nineteen quantitative models for assessment of localized left ventricular wall motion abnormalities. Clin Cardiol 3:123–128
Cohn PF, Levine JA, Bergeron GA, Gorlin R (1974) Reproducibility of the angiographic left ventricular ejection fraction in patients with coronary artery disease. Am Heart J 88:713–720
Rogers WJ, Smith LR, Hood WP Jr, Mantle JA, Rackley CE, Russell RO Jr (1979) Effect of filming projection and interobserver variability on angiographic biplane left ventricular volume determination. Circulation 59:96–104
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Sigel, H., Nechwatal, W., Kress, P. et al. Interobserver and intermethod variation in evaluation of regional wall motion of the left ventricle. Cardiovasc Intervent Radiol 6, 14–19 (1983). https://doi.org/10.1007/BF02552787
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DOI: https://doi.org/10.1007/BF02552787