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Ventricular Performance in Congenital Left-to-Right Shunt: Temporal Fourier Analysis of Gated Blood-Pool Data

Mie University School of Medicine, Tsu, Japan

Correspondence: For reprints contact: Dr. Kan Takeda, Dept. of Radiology, Mie University School of Medicine, Tsu, Mie, Japan.

ABSTRACT

Using global time-activity curves, the phase and amplitude at fundamental frequency were calculated, and emptying patterns of the right and left ventricles (RV,LV) were evaluated by phase difference [D(phase) = RV phase minus LV phase] and RV/LV amplitude ratio [R(amp)]. In 21 subjects with normal cardiac function, D(phase) was minimal (mean 2.2 ± 6.1°), regardless of heart rate, and R(amp) was distributed from 0.31 to 0.92 (mean 0.57 ± 0.20). In 19 patients of ventricular septal defect (VSD), R(amp) remained within the normal range, whereas D(phase) became larger in proportion to the ratio of pulmonary-to-systemic blood flow, Qp/Qs (p <0.001). Especially, cases with Qp/Qs over 2.0 showed a significant RV phase lag. By contrast, nine patients with patent ductus arteriosus (PDA), showed no RV phase lag, but—particularly in cases with Qp/Qs > 2.0—R(amp) was smaller than normal (p <0.001). Thus this method is valuable for pathophysiologic investigation of diseases with L-to-R shunt, and can help in the noninvasive differential diagnosis between VSD and PDA.