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European Heart Journal 1991 12(5):573-582;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Determination of left ventricular systolic wall thickness by digital subtraction angiography

M. JAKOB, O. M. HESS, R. JENNI, J. T. HEYWOOD, J. GRIMM and H. P. KRAYENBUEHL

Medical Policlinic, Cardiology, University Hospital Zurich, Switzerland

Received 29 January 1990; revised 2 July 1990; .

Correspondence: Otto M. Hess, Medical Policlinic, Cardiology, University Hospital, Raemistrasse 100, 8091 Zurich, Switzerland

Abstract

The accuracy of digital subtraction angiography (DSA) for determination of left ventricular (LV) systolic wall thickness and muscle mass was evaluated in 20 patients (mean age 50±11 years). Conventional LV angiograms were digitized and subtracted using a combined subtraction mode (‘mask mode’ and ‘time interval difference’ subtraction). Wall thickness and muscle mass were determined at end-diastole, after the first- and second-third of systole and at end-systole. M-mode echo- cardiography (Echo), which was obtainedfrom beam selection of the two-dimensional echocardiogram and conventional angiography (LVA), served as reference techniques. Angiographic LV wall thickness and muscle mass were determined according to the technique of Rackley in both, right (RAO) and left (LAO) anterior oblique projections, whereas echocardiographic wall thickness was measured just below the mitral valve orthogonal to the posterior wall (= LAO equivalent). Percent wall thickening was calculated in all patients.

LV end-diastolic wall thickness and muscle mass correlated well between DSA and LVA (LV end-diastolic wall thickness in LAO projection r=0·72, biplane LV end-diastolic muscle mass r=0·83 LV end-systolic wall thickness (1·44 vs 1·33 cm, P<0·05) and percent wall thickening (52 vs 42%, P<0 comparedfavourably between echocardiography and DSA but was sign larger when echocardiographically measured than with DSA (LAO projection). DSA and echocardiography showed a good correlation in regard to LV end-diastolic and end-systolic wall thickness (correlation coefficient r=0·89, standard error of estimate SEE =0·15 cm or 13% of the mean value). There were only minimal changes in LV biplane muscle mass (DSA)from end-diastole to end-systole (+ 4%).

It is concluded that both LV end-diastolic and end-systolic wall thickness and muscle mass can be determined accurately by DSA. Systolic wall thickening is systematically overestimated by M-mode echocardiography compared to DSA due to the overestimation of end-systolic wall thickness.

Key Words: Digital subtraction angiography • conventional angiography • echocardiography • left ventricular wall thickness • left ventricular muscle mass


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