Assessment of left ventricular function by synchronous echocardiography and apex cardiography

Use of computer analysis of echocardiograms for assessment of left ventricular function

Computer analysis of M-mode echocardiograms has been used for evaluation of left ventricular function. Ventricular dimensions and velocities of heart wall movement have been measured. In addition, a non-invasive estimate of ventricular wall stress has been obtained using the systolic cuff blood pressure combined with echocardiogram data, and simultaneous apex cardiography has been employed to look for any disruption in the timing of changes in ventricular dimension and wall stress. Various parameters have been calculated from the data to provide a quantitative indication of changes in the ventricle. A study has been carried out of 117 patients divided into four groups; one of normal subjects and the others containing patients with ischaemic heart disease, hypertrophic cardiomyopathy and dilated cardiomyopathy. Abnormal features of the echocardiograms have been evaluated from comparisons with data for normal subjects. Relationships between the quantities measured have been studied to give a fuller understanding of changes taking place in the ventricle, so that the data can be employed as the basis for a non-invasive assessment of ventricular function.

Significance of asymmetrically inverted T wave

Two consecutive series of patients with a T wave asymmetry ratio of 2.0 or greater have been studied. Patients with bundle-branch block or who were on digoxin or a similar drug were excluded. In 50 of the 69 patients, the heart was examined either by echocardiography or by direct inspection. Sixty-one of the 69 patients had diseases commonly associated with left (or right) ventricular hypertrophy and/or dilatation. The remaining eight patients had clinically pure ischaemic heart disease. Of the 50 hearts examined by echocardiography or direct inspection (including six with pure ischaemic heart disease), 49 were found to have abnormal thickness of the left (or right) ventricle, or increased end-diastolic left ventricular diameter, or a combination of hypertrophy and dilatation. In 12 of the 47 patients with left ventricular hypertrophy or dilatation, the electrocardiogram did not satisfy the Sokolow and Lyon voltage criterion of left ventricular hypertrophy.