Validation of pressure-volume data obtained in patients by initial transit radionuclide angiocardiography
In order to validate the measurement of pressure-volume loops and stroke work in humans, simultaneous digital subtraction ventriculography (DSA) and first-pass radionuclide angiocardiography (RNA) coupled with high-fidelity micromanometer left ventricular pressure measurements were undertaken in 34 patients, mean age 75 ± 9 years, with aortic stenosis. Twenty-nine patients had a repeat study after balloon valvuloplasty, for a total of 63 DSA and RNA pressure-volume loops. All data were analyzed in a systematic fashion in order to minimize intra- and interobserver error. Linear regression analysis was used to calculate the degree of agreement between the two technologies. Left ventricular ejection fraction (RNA: 0.47 ± 0.17, DSA: 0.49 ± 0.18) had a correlation coefficient of 0.96; left ventricular end-diastolic volume (RNA: 171 ± 42 ml, DSA: 168 ± 52 ml) and end-systolic volume (RNA: 95 ± 50 ml, DSA: 89 ± 50 ml) had correlation coefficients of 0.89 and 0.95, respectively. Left ventricular stroke volume (RNA: 75 ± 26 ml, DSA: 75 ± 27 ml) had a correlation coefficient of 0.92, while integrated pressure-volume loop or stroke work (RNA: 15.6 ± 6.6 ergs 106, DSA: 15.9 ± 6.3 ergs 106) had a correlation coefficient of 0.89. These data demonstrate that RNA measurements of left ventricular chamber dynamics concur with that obtained with DSA. With semiautomated data analysis, the portable first-pass RNA pressure-volume data are also less labor-intensive. Moreover, multiple measurements of ventricular performance during hemodynamic manipulations in the catheterization laboratory or operating room would allow for a more precise estimation of left ventricular performance. © 1989.
Harpole, DH; Skelton, TN; Davidson, CJ; Jones, RH; Bashore, TM
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