Measurement of left ventricular mass by contrast ventriculography

BACKGROUND: Elevated left ventricular mass (LVM) has been shown to be an important predictor of adverse cardiac events. Calculation of LVM using contrast ventriculography, as described by Rackley, involves measuring left ventricular wall thickness in a single plane, with assumptions made about ventricular geometry. HYPOTHESIS: We hypothesized that a modification of the Rackley method, involving multiple measurements of left ventricular (LV) wall thickness in 2 orthogonal planes, may add value in the determination of LVM in patients with LV remodeling and dysfunction. METHODS: The LVM was determined in 24 patients with LV dysfunction who had undergone both cardiac magnetic resonance imaging (CMRI) and contrast left ventriculography. Right anterior oblique (RAO) and left anterior oblique (LAO) still frames in diastole were used to measure LV length, chamber area, and wall thickness. From these variables, LV volume, myocardial volume, and LVM were calculated. The LVM calculations using an average wall thickness from the LAO and RAO projections were compared with LVM measured by CMRI. RESULTS: Eighty eight percent of patients had hypertension, 100% had coronary artery disease, and mean left ventricular ejection fraction by contrast left ventriculography was 41 +/- 14%. Averaging left ventricular wall thickness from RAO and LAO projections using biplane ventriculography for LVM calculation yielded a strong correlation (r = 0.77, p < 0.01) with LVM calculated from CMR. CONCLUSIONS: In patients with left ventricular dysfunction, biplane left ventricular wall thickness measurements for contrast ventriculography LVM calculations render a strong correlation with LVM calculated by CMRI.