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ARTICLE |

Ventriculographic-Echocardiographic Correlation in Patients With Asynergy FREE

Carol A. Morrison, MD; Monty M. Bodenheimer, MD; Michael S. Feldman, MD; Vidya S. Banka, MD; Richard H. Helfant, MD
[+] Author Affiliations

Reprint requests to Division of Cardiology, Presbyterian-University of Pennsylvania Medical Center, 51 N 39th Street, Philadelphia, PA 19104 (Dr Helfant).


JAMA. 1978;239(18):1855-1859. doi:10.1001/jama.1978.03280450027018
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The ability of echocardiography to detect segmental ventricular asynergy was evaluated in 41 patients before cardiac catheterization. Of 24 normal posterior wall segments by echocardiography, 23 were also normal by ventriculography, while one was hypokinetic. Of 17 asynergic posterior wall segments by echocardiography, 15 were asynergic and two were normal by ventriculography. Posterior wall excursion for the normal group was 1.30± 0.18 cm (SD), while those demonstrating hypokinesis on ventriculography showed an excursion of 1.05±0.19 cm (P<.005), and akinetic segments showed an excursion of 0.97±0.13 cm (P<.005).

In 15 patients, septal motion as determined by echocardiography was compared with the left anterior oblique ventriculogram. Of nine normal septal motions by echocardiography, seven were also normal by left anterior oblique ventriculography (septal excursion, 0.84±0.25 cm). Of six patients with decreased echocardiographic septal motion, four were normal and two were abnormal by ventriculography. Although normal echocardiographic septal motion correlated well with ventriculography, decreased septal excursion by echocardiography did not.

(JAMA 239:1855-1859, 1978)

REFERENCES

McDonald IG, Feigenbaum H, Chang S:  Analysis of left ventricular wall motion by reflected ultrasound: Application to assessment of myocardial function . Circulation 46:14-25, 1972;.
Murray JA, Johnston W, Reid JM:  Echocardiographic determination of left ventricular dimensions, volumes and performances . Am J Cardiol 30:252-257, 1972;.
Fortuin NJ, Hood WP, Craige E:  Evaluation of left ventricular function by echocardiography . Circulation 46:26, 1972;.
Belenkie I, Nutter DO, Clark DW, et al:  Assessment of left ventricular dimensions and function by echocardiography . Am J Cardiol 31:755-762, 1973;.
Ludbrook P, Karliner JS, Peterson K, et al:  Comparison of ultrasound and cineangiographic measurements of left ventricular performance in patients with and without motion abnormalities . Br Heart J 35:1026-1032, 1973;.
Kisslo J, Wolfson S, Ross A, et al:  Ultrasound assessment of left ventricular function following aortocoronary saphenous vein bypass grafting . Circulation 48( (suppl 3) ):156-161, 1973;.
Ratshin RA, Boyd CN Jr, Rackley CE, et al:  Quantitative echocardiography: Correlations with ventricular volumes by angiocardiography in patients with coronary artery disease with and without wall motion abnormalities , abstracted. Circulation 48( (suppl 4) ):48, 1973;.
Corya BC, Feigenbaum H, Rasmussen S, et al:  Echocardiographic features of congestive cardiomyopathy compared with normal subjects and patients with coronary artery disease . Circulation 49:1153-1159, 1974;.
Inoue K, Smulyan H, Mookherjee S, et al:  Ultrasonic measurement of left ventricular wall motion in acute myocardial infarction . Circulation 43:778-785, 1971;.
Jacobs JJ, Feigenbaum H, Corya BC, et al:  Detection of left ventricular asynergy by echocardiography . Circulation 48:263, 1973;.
Corya BC, Feigenbaum H, Rasmussen S, et al:  Anterior left ventricular wall echoes in coronary artery disease: Linear scanning with a single element transducer . Am J Cardiol 34:652-657, 1974;.
Teichholz LE, Cohen, MV, Sonnenblick EH, et al:  Study of left ventricular geometry and function by B-scan ultrasonography in patients with and without asynergy . N Engl J Med 291:1220-1226, 1974;.
Kraunz RF, Kennedy JW:  Ultrasonic determination of left ventricular wall motion in normal man: Studies at rest and after exercise . Am Heart J 79:36-43, 1970;.
Popp RL, Wolfe SB, Hirata T, et al:  Estimation of right and left ventricular size by ultrasound: A study of the echoes from the interventricular septum . Am J Cardiol 24:523-530, 1969;.
Herman MV, Heinle RA, Klien MD, et al:  Localized disorders in myocardial contraction: Asynergy and its role in congestive heart failure . N Engl J Med 277:222, 1967;.
Helfant RH, Pine RP, Meister SG, et al:  Nitroglycerin to unmask reversible asynergy: Correlation with post-coronary bypass ventriculography . Circulation 50:108, 1974;.
Banka VS, Bodenheimer MM, Helfant RH:  Determinants of reversible asynergy: Effect of pathologic Q waves, coronary collaterals and anatomic location . Circulation 50:714, 1974;.
Assad-Morell JL, Tajik AJ, Giuliani ER:  Echocardiographic analysis of the ventricular septum . Prog Cardiovasc Dis 17:219-236, 1974;.
Browne OR, Popp RL, Harrison DC:  Abnormal interventricular septal motion in patients with significant disease of the left anterior descending coronary artery or other conditions of septal failure , abstracted. Am J Cardiol 31:123, 1973;.
Pearlman AS, Morganroth J, Henry WL, et al:  Determinants of ventricular septal motion , abstracted. Am J Cardiol 35:162, 1975;.

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McDonald IG, Feigenbaum H, Chang S:  Analysis of left ventricular wall motion by reflected ultrasound: Application to assessment of myocardial function . Circulation 46:14-25, 1972;.
Murray JA, Johnston W, Reid JM:  Echocardiographic determination of left ventricular dimensions, volumes and performances . Am J Cardiol 30:252-257, 1972;.
Fortuin NJ, Hood WP, Craige E:  Evaluation of left ventricular function by echocardiography . Circulation 46:26, 1972;.
Belenkie I, Nutter DO, Clark DW, et al:  Assessment of left ventricular dimensions and function by echocardiography . Am J Cardiol 31:755-762, 1973;.
Ludbrook P, Karliner JS, Peterson K, et al:  Comparison of ultrasound and cineangiographic measurements of left ventricular performance in patients with and without motion abnormalities . Br Heart J 35:1026-1032, 1973;.
Kisslo J, Wolfson S, Ross A, et al:  Ultrasound assessment of left ventricular function following aortocoronary saphenous vein bypass grafting . Circulation 48( (suppl 3) ):156-161, 1973;.
Ratshin RA, Boyd CN Jr, Rackley CE, et al:  Quantitative echocardiography: Correlations with ventricular volumes by angiocardiography in patients with coronary artery disease with and without wall motion abnormalities , abstracted. Circulation 48( (suppl 4) ):48, 1973;.
Corya BC, Feigenbaum H, Rasmussen S, et al:  Echocardiographic features of congestive cardiomyopathy compared with normal subjects and patients with coronary artery disease . Circulation 49:1153-1159, 1974;.
Inoue K, Smulyan H, Mookherjee S, et al:  Ultrasonic measurement of left ventricular wall motion in acute myocardial infarction . Circulation 43:778-785, 1971;.
Jacobs JJ, Feigenbaum H, Corya BC, et al:  Detection of left ventricular asynergy by echocardiography . Circulation 48:263, 1973;.
Corya BC, Feigenbaum H, Rasmussen S, et al:  Anterior left ventricular wall echoes in coronary artery disease: Linear scanning with a single element transducer . Am J Cardiol 34:652-657, 1974;.
Teichholz LE, Cohen, MV, Sonnenblick EH, et al:  Study of left ventricular geometry and function by B-scan ultrasonography in patients with and without asynergy . N Engl J Med 291:1220-1226, 1974;.
Kraunz RF, Kennedy JW:  Ultrasonic determination of left ventricular wall motion in normal man: Studies at rest and after exercise . Am Heart J 79:36-43, 1970;.
Popp RL, Wolfe SB, Hirata T, et al:  Estimation of right and left ventricular size by ultrasound: A study of the echoes from the interventricular septum . Am J Cardiol 24:523-530, 1969;.
Herman MV, Heinle RA, Klien MD, et al:  Localized disorders in myocardial contraction: Asynergy and its role in congestive heart failure . N Engl J Med 277:222, 1967;.
Helfant RH, Pine RP, Meister SG, et al:  Nitroglycerin to unmask reversible asynergy: Correlation with post-coronary bypass ventriculography . Circulation 50:108, 1974;.
Banka VS, Bodenheimer MM, Helfant RH:  Determinants of reversible asynergy: Effect of pathologic Q waves, coronary collaterals and anatomic location . Circulation 50:714, 1974;.
Assad-Morell JL, Tajik AJ, Giuliani ER:  Echocardiographic analysis of the ventricular septum . Prog Cardiovasc Dis 17:219-236, 1974;.
Browne OR, Popp RL, Harrison DC:  Abnormal interventricular septal motion in patients with significant disease of the left anterior descending coronary artery or other conditions of septal failure , abstracted. Am J Cardiol 31:123, 1973;.
Pearlman AS, Morganroth J, Henry WL, et al:  Determinants of ventricular septal motion , abstracted. Am J Cardiol 35:162, 1975;.
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