[Use of quantitative methods in cineangiocardiography: a comparison of 9 methods of motion analysis for the detection of regional function in patients with coronary heart disease].

In order to evaluate the usefulness of various quantitative methods for the assessment of regional left ventricular function, a total of 9 methods (3 hemiaxial models, 1 area model and 5 radial-axes models) were applied to the radiopaque ventriculograms of 16 patients with anterior wall infarction and 13 patients with posterior wall infarction. A series of 17 patients without clinical or angiographic evidence of heart disease were used as control group. While the hemiaxial methods were consistently found to be useful and reproducible, the area method did not provide significant additional information. The diagnostic accuracy was highest with the use of 2 radial-axes methods. The sensitivity and specificity data were 90% to 100% and 70% to 100%, respectively. The remaining 3 radial-axes methods were found to be of limited value since regional wall motion abnormalities were projected to the contralateral wall. Because of this methodological shortcoming these techniques may falsely indicate asynergy in areas with normal contraction patterns. This was reflected by high sensitivity but low specificity values. A feature of the latter 3 methods was the use of the gravity center of the end-systolic frame as the reference point. The position of this reference point is decisively influenced by the extent and localization of asynergy. These findings suggest that methods using the gravity center of the end-systolic frame should not be employed in the evaluation of regional left ventricular function. In general, some quantitative methods for assessing regional left ventricular function require a considerable expense for technical apparatus which is not always justified by the extent to which additional information is gained.