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Left-Ventricular Ejection Fraction and Segmental Wall Motion by Peripheral First-Pass Radionuclide Angiography

Wadsworth Veterans Administration Hospital and University of California at Los Angeles, Los Angeles, California

Correspondence: For reprints contact: Harvey S. Hecht, Cardiology Div., Wadsworth Veterans Administration Hospital, Wilshire and Sawtelle Blvds, Los Angeles, CA 90073.

ABSTRACT

A computerized edge-detection method was developed to obtain radionuclide ventriculograms for analysis of left-ventricular ejection fraction and segmental wall motion from first-pass studies following i.v. injection of radionuclide. The accuracy of this technique was examined in 21 patients undergoing cardiac catheterization. Tc-99m DTPA was injected into an antecubital vein, with data acquisition in the 30° RAO projection by a gamma scintillation camera interfaced to a computer. A computerized profile analysis was used to determine objectively the edge of the left-ventricular blood pool. Time-activity curves were generated, and the ejection fraction was calculated from sequential end-diastolic and end-systolic count rates. The values for ejection fraction correlated well with those obtained by single-plane contrast ventriculography (r = 0.95). End-diastolic and end-systolic images were reconstructed from the time-activity curve. To analyze segmental wall motion, the left-ventricular outline was divided into five segments and the motion of each segment was graded qualitatively from 1 to 5. Seventy-five of 105 segments had the same grade as the wall motion determined by contrast angiography, and 102 of 105 were within one grade. (P < 0.001). These findings demonstrate the accuracy of this improved technique for objective, rapid, and noninvasive determination of left-ventricular function.