VENTRICULOGRAPHY
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| MEASUREMENT OF LEFT VENTRICULAR FUNCTION USING VENTRICULOGRAPHY |
In ventriculography a catheter (usually pigtail) is introduced into the ventricle and radiopaque contrast material injected (see Plate 3-17). The ventricle is then visualized by fluoroscopy/cine as it contracts and relaxes, to assess ventricular wall motion and calculate ejection fraction (EF; normal ≥55%). Ejection fraction is calculated by the formula EF = SV/EDV, where SV is stroke volume and EDV end-diastolic volume.
Hemodynamic
study for ischemic heart disease is incomplete without assessment of
ventricular function. Catheter-based ventriculography enables identification of
areas of akinesis or hypokinesis and allows measurement of global EF if an LAO
view is obtained. This information complements coronary angiography; for
example, areas of hypokinesis corresponding to the distribution of the coronary
arteries with stenotic lesions may provide information that encourages the
physician to perform PCI or cardiac surgery to improve contraction of that part
of the ventricle.
Ventriculography
can be performed in both right (RAO) and left (LAO) anterior oblique
projections. In RAO view the anterior, apical, and inferior walls are
visualized. In LAO projection the septum, apex, and lateral wall are assessed
(see Plate 3-17).
