Feasibility of ventricular function analysis by digital subtraction angiography

Evaluation of the densitometric method of ejection fraction by direct digital subtraction left ventriculography

The aim of the present study was to test the hypothesis that the densitometric ejection fraction (EF) could be calculated by direct contrast digital subtraction left ventriculography in a single heartbeat. Thirty patients underwent direct contrast digital subtraction left ventriculography and biplane conventional left ventriculography. The values of EF were obtained from digital subtraction ventriculograms of the first cardiac cycle after completion of the injection of the contrast medium by the videodensitometric technique and were compared with those obtained from conventional ventriculograms by the area-length method in the same patients. There was a close correlation between the densitometric EF from digital subtraction ventriculograms and the volumetric EF from conventional ventriculograms (r = 0.78). Densitometric EF measured in the 30 degree right anterior oblique projection highly correlated with densitometric EF measured in the 60 degree left anterior projection (r = 0.98). These data suggest that this densitometric technique is available in any projection and is a simple procedure for the accurate measurement of left ventricular EF.

Determination of left ventricular volumes with use of DSA density values

A computer program was developed to obtain left ventricular volumes from the density values of DSA. The highest density value along the horizontal pixel line over the left ventricle in 30 degrees RAO was considered to correspond to the greatest width on the same level of 60 degrees LAO. The left ventricular volume was obtained by converting the density values into the width and integrating these values. This method estimated experimental balloon volumes with considerable accuracy. Clinical evaluation revealed good correlation between DSA and conventional cine left ventriculography.