Evaluation of left ventricular function by cardiac catheterization, echocardiography, and systolic time intervals

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Assessment of left ventricular function is of primary importance in the evaluation of various forms of organic heart disease. Direct hemodynamic and angiographic measurements at cardiac catheterization have previously been the only standard method for obtaining this information.1

In the past decade systolic time intervals and echocardiography have been developed as alternative noninvasive techniques for deriving this information.2–8 Both systolic time intervals and echocardiography, because of their noninvasive nature, may be performed serially at no patient risk or discomfort, and thus provide a convenient method of evaluating and following left ventricular performance.

In patients with left ventricular dysfunction, a good correlation has been found between systolic time intervals and ejection fraction derived at cardiac catheterization.9 Several studies have demonstrated a good correlation of different parameters of left ventricular function between echocardiography and direct measurements obtained at cardiac catheterization.3–6 The limitations of echocardiography in assessing overall ventricular function by studying only a small area of the ventricle have recently been emphasized.10

The aim of this project was to define quantitatively a set of noninvasive measurements that have the greatest correlation with directly obtained information on left ventricular performance in normal subjects and in patients with segmental or diffuse left ventricular dysfunction. We have also determined the discriminative power of these techniques in differentiating the normal population from patients with coronary artery disease and normal and abnormal ventricles, and patients with primary myocardial disease. Theoretically, several indirect measurements in combination should yield a more sensitive indicator of ventricular function than. . .



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