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At least 19 recordsLinked to original sources
PubMed1984

[Digital subtraction angiocardiography--an alternative to traditional angiocardiography?].

Intravenous (i.v.) digital angiography has been extensively and successfully used for studying peripheral arterial vessels. Its application in the heart now results in high resolution images of the cardiac chambers. Accuracy and reproducibility of left ventricular volume determination equal that of conventional cineangiocardiography. Thus, left ventricular regional and global function can be analyzed quantitatively at rest and during exercise with higher simplicity and lower risk even on an outpatient basis by i.v. digital subtraction angiocardiography. To date, however, the coronary artery system cannot be visualized by digital image processing using i.v. injection of contrast medium, i.e., in patients win whom the coronary arteries have to be examined, selective arteriography for the future, too, will be combined with direct left ventricular angiocardiography. Regarding clinical experience till now, digital subtraction angiocardiography must be characterized as a complementary rater than an alternative method to conventional cineangiocardiography.

Angiocardiography↗
PubMed1982

Comparison of left ventricular ejection fraction assessed by radionuclide angiocardiography, echocardiography and contrast angiocardiography.

The left ventricular ejection fraction (EF) obtained by first pass radionuclide angiocardiography was compared with that determined by contrast angiocardiography in 49 patients. In 35 of the patients a comparison with the EF obtained by M-mode echocardiography was also made. The EF echo was determined in two ways, from the standard cube formula and the regression equation suggested by Teichholz for left ventricular volume calculations. The latter formula gave an average EF closer to the average EF obtained by isotope technique and cineangiography and was therefore used in the comparison study. Measurements of EF by isotope technique and echocardiography correlated well (r = 0.78). The correlation between these two noninvasive methods for EF determination and their cineangiographic counterpart was almost identical (r = 0.72--0.74).

Adult↗
PubMed1984

[Digital subtraction angiocardiography: accuracy of measuring left ventricular wall thickness and wall volume during intravenous contrast media injection].

A comparison of left ventricular wall thickness and wall volume determined by intravenous digital subtraction angiocardiography and by conventional left ventricular angiocardiography was performed by linear regression analysis: wall thickness: WDDSA = 0.90 X WDLV , Syx = +/- 0.16 cm, r = 0.74; wall volume: WVOLDSA = 0.87 X WVOLLV , Syx = +/- 48 ml, r = 0.85. Compared to the deviation and scatter of corresponding data measured from two consecutive beats in conventional left ventricular angiocardiographies , the error of determination of wall thickness and wall volume, determined by intravenous digital subtraction angiocardiography, is more pronounced. The regression analysis of wall volumes under rest and bicycle exercise evaluated by digital subtraction angiocardiography revealed a similar inaccuracy ( Syx = +/- 46 ml). This is due to faults in recognition of the inner and outer contours of left ventricular wall. Our results show that measurements of left ventricular wall thickness and wall volumes by means of intravenous digital subtraction angiocardiography can only be performed with greater deviations compared to conventional left ventricular angiocardiograms.

Angiocardiography↗
PubMed1984

Right ventricular imaging with digital subtraction angiocardiography using intraventricular contrast injection.

Angiocardiography is of considerable value in the dimensional analysis of the right ventricular (RV) cavity, but conventional angiocardiography requires large amounts of contrast medium. In this study digital subtraction angiocardiography was applied to biplane RV projections of 25 children with congenital heart disease after direct injection of a small dose of contrast medium. Volume measurements were compared with those obtained by conventional angiocardiography. The amount of contrast medium required was reduced to 30%, flow rate to 57% and ventricular ectopic activity to 60% of that used in conventional angiocardiography, and the degree of radiation exposure was reduced considerably. There was a good correlation for end-diastolic (r = 0.996) and end-systolic volume (r = 0.990) determined with both techniques. Digital subtraction angiography after selective RV injection allows accurate volume measurements of the right ventricle in children with congenital heart disease. The main benefits of this method are reduction of the amount of contrast medium, flow rate during injection, radiation and ventricular ectopic activity.

Adolescent↗
PubMed1979

[Angiocardiography in the diagnosis of congenital bulboventricular heart defects. Anatomopathological and angiocardiographic correlations].

Current surgical methods enable radical treatment of the most bulboventricular malformations (syn. conotruncal malformations, transposition complex). The defects, which were until now the field of embryologist and pathologist, require accurate and precise clinical diagnosis of the anomaly. The purpose of this analysis was to estimate the ability of angiocardiography for diagnosis of bulboventricular malformations considering the type of essential anomaly, its exact morphology and character of coexisting malformations. The report represents 49 cases with pathological diagnosis of bulboventricular malformations in children, in which during hospitalization angiocardiography has been performed. The cases were selected from 1918 angiocardiographies and also from 987 cases of pathological specimens with congenital heart diseases in the years 1970-1977. There were: 33 cases of TGA, in these 2 with corrected TGA, 3 cases of DORV, 1 case of DOLV , 12 cases of CV. All cases showed the broad spectrum of variants in position of the great arteries and kind of conus apart from type of basic anomaly. Septal defects, pulmonary orifice stenosis or atresia and anomalies of atrio-ventricular orifices particularly in common ventricle were mostly coexisting malformations. To recognize essential anomaly we estimated atrio-ventricular and ventriculo-arterial relation (connection), based on Kirklin classification. The conuses and position of the trunk of the great arteries were treated as pathomorphologic details, that had no influence on essential diagnosis of malformation. Arbitrary accepted definition and nomenclature was based on data from bibliography. Angiocardiography was made using full-size filmchanger AOT with maximal frequency 6 frames/sec. Contrast medium injected mainly into the ventricles. X-rays were performed usually immediately in two projections. Comparison of the angiocardiographic diagnosis with pathology of the hearts showed the correct diagnosis of the essential malformation, by means of angiocardiography, in more than 80% cases. But the diagnosis percentage in particular elements of malformation varied from 2/3 to 1/3 according to the type of malformation. The absence of the correct diagnosis of the essential anomaly, based on type of relations, was the lack of visualization of all heart cavities (in some cases), which was conditioned by the method. On the other hand the correct angiocardiographic diagnosis was sometimes impossible, because of very complicated anatomical situation in malformed hearts.(ABSTRACT TRUNCATED AT 400 WORDS)

Angiocardiography↗
PubMed1976

Quantitative radionuclide angiocardiography: detection and quantitation of left to right shunts.

In 105 patients defection and quantitation of left to right shunts was performed using quantitative radionuclide angiocardiography. The radionuclide angiocardiograms were acquired and analyzed by a gamma camera interfaced to a digital computer system. Pulmonary to systemic flow (Qp/As) ratios were calculated by analysis of pulmonary time-activity histograms using a gamma variate model. All patients were studied with cardiac catheterization, left ventricular angiocardiography and radionuclide angiocardiography. The radionuclide method allowed precise detection and quantitation of left to right shunts with a Qp/Qs ratio of 1.2 to 3.0. There was good agreement between the Ap/As ratio calculated by oximetry at cardiac catheterization and radionuclide angiocardiography (r = 0.94). The information gathered with this nontraumatic method appears sufficiently reliable to be used in the management of patients.

Adult↗
PubMed1975

A modified technique for transseptal angiocardiography: review of 186 cases.

Perforations of the left atrial or ventricular wall and extravasations of contrast medium during transseptal left heart catheterisation or angiocardiography can be eliminated by replacing the normally used transseptal catheters by Pigtail-catheters. With only 2.8% minor complications without sequelae in 181 successful studies, transseptal angiocardiography of the left heart through Pigtail-catheters is not only less hazardous than injections through the transseptal catheters used up to now, but possibly bears even less risk than direct retrograde injection into the left ventricle. The best method of showing the left atrial cavity and the mitral valve is transseptal left atrial injection. According to our findings in the evaluation of the ventricular function by means of quantitative angiocardiography, transseptal angiocardiography with injection into the left atrium is preferable to retrograde direct ventriculography, as ventricular ectopic beats were absent and supraventricular ectopic beats were as rare as 5% of cases. With this method, local disturbances of wall motion during injection could also be avoided and one or two more cycles could be evaluated before the depressant effect of contrast medium started.

Angiocardiography↗
PubMed1975

[Modern differentiation possibilities of angiocardiography in childhood].

1. Angiocardiography plays an irreplaceable method of investigation in the diagnosis of cardiac diseases in infancy and childhood. In many cases it is the "crown" of the diagnosis. 2. Cine-angiocardiography is indispensable in paediatric cardiology. In infancy, in rapid heart rates and in complicated malformations of the heart, only a movie film (35 mm) can register completely all the anatomic and haemodynamic details. 3. In certain cases the serial angiocardiography is also necessary in childhood. Today two methods of radiography can be made use of: the direct recording by means of rapid film changers on full size X-ray films and the indirect method on 70- or 100-mm size films. 4. According to our experience, the serial angiocardiography recordings on 70-mm size films have more advantages than the usual full size films (35 x 35 cm). In the interpretation of the 70-mm-size films there is no loss of information, and the radiators dose is 1/10 lower than in AOT-size.

Age Factors↗
PubMed1987

Regional dysfunction by equilibrium radionuclide angiocardiography: a clinicopathologic study evaluating the relation of degree of dysfunction to the presence and extent of myocardial infarction.

The relation of degree of regional wall motion abnormality by equilibrium radionuclide angiocardiography to the presence and mural extent of regional necrosis or scar at autopsy was evaluated in 23 autopsy patients who had a history of myocardial infarction and had equilibrium radionuclide angiocardiography within 40 days of death. Of the 228 regions evaluated by equilibrium radionuclide angiocardiography, 135 had abnormal regional wall motion and 102 (76%) of these 135 regions had evidence of myocardial infarction at autopsy. The overall sensitivity, specificity and predictive values of regional wall motion abnormality for regional necrosis or scar were 69, 59 and 76%, respectively. Of the 33 false positive regions, 20 (61%) had severe narrowing of the coronary artery supplying that region, 13 (39%) were adjacent to a region with a myocardial infarction and almost half (16 [48%]) were in the lateral wall. Eighty-three (36%) of the 228 regions were akinetic or dyskinetic, 52 (23%) were hypokinetic and 93 (41%) were normal. Sixty-three (76%) of the 83 akinetic/dyskinetic segments had transmural myocardial infarction at autopsy, 14 (17%) had nontransmural myocardial infarction and only 6 (7%) contained no necrosis or scar. In contrast, 14 (27%) of 52 hypokinetic segments had transmural myocardial infarction, 11 (21%) had nontransmural myocardial infarction and 27 (52%) were normal. Thus, the most severe regional wall motion abnormality (akinesia/dyskinesia) almost always indicates regional myocardial infarction which is usually transmural whereas less severe dysfunction (hypokinesia) is not necessarily associated with regional necrosis or scar. The severity of regional dysfunction must be considered if equilibrium radionuclide angiocardiography is used to evaluate the presence and mural extent of myocardial infarction within a region.

Adult↗
PubMed1981

Evaluation of left ventricular performance and of its reserve by radionuclide angiocardiography: comparison with other methods.

This study was performed, i) to compare radionuclide angiocardiography with the other methods, and ii) to evaluate its usefulness in investigating left ventricular performance and its reserve. Radionuclide angiocardiography, chest X-ray film, chest X-ray cinegraphy, echocardiography, two-dimensional echocardiography, pulsed Doppler flowmetry, cardiokymography, myocardial imaging, contrast ventriculography and coronary arteriography were performed (:also at exercise) in 105 subjects including various kinds of cardiac patients. Radionuclide angiocardiography could be performed both at rest and at exercise, contrary to invasive methods. In detailed analysis of left ventricular mechanics in non-ischemic heart disease, echocardiography at rest and at exercise may be appropriate, because of its high image resolution. In evaluation of ischemic heart diseases, radionuclide angiocardiography at rest and at exercise might be appropriate, because of bidirectional informations and its high success rate. Two-dimensional echocardiography with M-mode echocardiography might compensate for it, particularly for continuous informations during exercise. Detection of regional wall motion dysfunction at exercise is more specific than exercise ECG and is more sensitive than exercise myocardial imaging. From many kinds of examinations, appropriate one should be selected according to the purpose of investigators. Much more technical progress in these methods can be expected.

Adolescent↗
PubMed1991

Prediction of death and myocardial infarction by radionuclide angiocardiography in patients with suspected coronary artery disease.

The prognostic value of radionuclide angiocardiography was examined in patients with suspected coronary artery disease. Nine hundred and eight patients who underwent rest and exercise radionuclide angiocardiography without subsequent cardiac catheterization were followed for a median of 4.6 years. Fifty-two cardiovascular deaths and 28 nonfatal myocardial infarctions occurred during the follow-up period. Thirty-nine radionuclide angiocardiographic and clinical variables were analyzed in association with the end points of cardiovascular death, total cardiac events and death from all causes using the Cox proportional hazards model and Kaplan-Meier survival estimates. Univariable analysis identified the exercise ejection fraction as the best predictor of cardiovascular death (chi-square = 82), total cardiac events (chi-square = 84) and death from all causes (chi-square = 66). A small subset of patients (n = 45) with an exercise ejection fraction less than 0.35 were at high risk for future cardiac events, whereas most patients (n = 776) had an exercise ejection fraction greater than or equal to 0.50 and a low probability of a subsequent event. Three variables--the exercise ejection fraction, the exercise change in heart rate, and gender--contained independent prognostic information determined by multivariable analysis. The exercise ejection fraction was the strongest independent predictor (p less than 0.0001) for every end point. The measurement of ventricular function during exercise provides important independent prognostic information in patients with suspected coronary artery disease. Radionuclide angiocardiography successfully identifies patients requiring invasive assessment, and the low probability of cardiac events in patients with good exercise ventricular function obviates the need for interventional therapy.

Adult↗
PubMed1993

Net costs from three perspectives of using low versus high osmolality contrast medium in diagnostic angiocardiography.

OBJECTIVES: We conducted an economic analysis to assess the extent to which a reduction in adverse drug reactions induced by low osmolality compared with high osmolality contrast media during diagnostic angiocardiography would result in savings to hospitals, society and third-party payers that would offset the substantially higher price of low osmolality contrast medium. BACKGROUND: Substitution of low osmolality for high osmolality contrast media in the approximately 1 million diagnostic angiocardiographic procedures performed each year in the United States could substantially increase health care costs. Cost-effectiveness estimates should include savings that might occur through reduced costs of managing adverse drug reactions. METHODS: In a randomized clinical trial of 505 persons under-going diagnostic angiography with either high osmolality or low osmolality contrast medium, we measured and compared 1) material costs of contrast media, and 2) costs from three perspectives of incremental resources used to manage contrast-related adverse drug reactions. We also performed sensitivity analyses to examine the effect of different assumptions with regard to relative risk, absolute risk and costs of adverse drug reactions on estimates of net cost of use of high osmolality and low osmolality contrast media. RESULTS: One-hundred thirty-seven (54.2%) of 253 patients receiving high osmolality contrast medium and 44 (17.5%) of 252 patients receiving low osmolality contrast medium experienced adverse drug reactions. The average cost (from society's perspective) of resources used to manage adverse drug reactions per patient undergoing angiography was significantly (p = 0.0001) greater for high osmolality (mean $249) versus low osmolality (mean $92) contrast medium. Differential costs (from the hospital's perspective) were $67 greater for high osmolality contrast medium. Charges and professional fees (from the payer's perspective) were $182 greater for high osmolality (mean $312) than for low osmolality (mean $130) contrast medium (p = 0.42, NS). The higher differential and average costs of managing adverse drug reactions with high osmolality contrast medium offset 33% and 75%, respectively, of the $207 difference in mean material costs, but these estimates are sensitive to infrequent high cost cases. CONCLUSIONS: Although low osmolality contrast medium is not cost-saving in diagnostic angiocardiography, its higher price is partially offset by lower management costs of adverse drug reactions. The cost offset for the hospital is lower than that for society and may not be realized by third-party payers. These methods and results may be useful in establishing clinical and payment guidelines for use of alternative contrast media in diagnostic angiocardiography.

Angiocardiography↗
PubMed1995

The post-angiocardiography urogram in children: should it be abandoned?

This study examines the value of the urogram radiograph taken after angiocardiography, in children with suspected congenital heart disease, to screen for co-existent urinary tract abnormalities. A retrospective audit of post-angiocardiography urograms over a three year period 1990 to 1993 is presented. 184 urograms obtained in 166 children were reviewed (86 males; mean age 18.1 months). Twenty-five urograms (13.6%) were obtained in cases where the urinary tract had previously been investigated. These urograms contributed no additional information. Image quality was suboptimal in 62 examinations (33.7%), due to gas, faeces or poor opacification, and two lesions were undetected on suboptimal radiographs. Urinary tract abnormalities were detected in 17 patients (10.2%). These lesions were also detectable at sonography. We suggest that routine post-angiocardiography urograms can be abandoned in favour of sonographic screening of the urinary tract in children with congenital heart disease.

Adolescent↗
PubMed1988

Left ventricular volume determination in dogs: a comparison between conductance technique and angiocardiography.

Left ventricular (LV) volume was determined simultaneously by monoplane cineangiocardiography and conductivity using a multielectrode conductance catheter at rest and during pressure loading in seven mongrel dogs (mean body weight 22 kg). LV volumes were calculated frame-by-frame (75 frames s-1) by angiocardiography and matched with instantaneous volumes obtained by conductivity. There was an excellent correlation between the two techniques at rest (correlation coefficient, r = 0.96) and during pressure loading (r = 0.92) when the data of each dog were pooled. The standard error of estimate of the mean angiographic volume was 4%. The slope of the regression analysis showed a small but significant (P less than 0.01) decrease from 0.365 at rest to 0.289 during pressure loading, whereas the intercept remained unchanged (24 versus 26 ml). Since no calibration for parallel conductivity of the surrounding tissue was performed, LV end-systolic volume was significantly over- and LV ejection fraction significantly underestimated whereas LV end-diastolic volume was estimated correctly by the conductance technique. It is concluded that LV end-diastolic volume can be determined accurately by the conductance technique in dogs. However, LV end-systolic volume is significantly over- and ejection fraction significantly underestimated. Since there is a good correlation between angiocardiography and conductivity, exact determination of LV volumes and ejection fraction is feasible using a correction factor. The change in slope of the regression equation between angiocardiography and conductivity suggests a change in conductivity of the surrounding tissue during pressure loading which limits the application of the conductance catheter to stable haemodynamic situations or calls for repeated calibrations by an independent technique during acute interventions.

Angiocardiography↗
PubMed1984

[Radiation exposure and radiation risk in angiocardiography in adults].

In 100 patients, the X-ray exposure during routine angiocardiography was measured from which calculations were performed for the integral dose (the energy transferred to the body by the exposure), the mean body dose and the radiation risk (according to ICRP 26, 1977). Fluoroscopy contributed 21% and angiocardiography 79% of the total exposure. The mean body dose was 0.9 rd. The average of the area-dose product was 10,200 Rcm2 with a skin exposure in the central beam of 36.1 rd. The genetic risk (probability of X-ray-induced mutation in progeny) is 1 : 75,000 after average exposures and 1 : 7,700 at maximal doses. The somatic risk (probability of X-ray-induced lethal disease) in the patients studied is 1 : 11,000 after average exposures and approximately 1 : 4,400 at maximal doses. The genetic and somatic risks, thus, are small as compared with those of cardiac catheterization and contrast angiocardiography.

Adult↗
PubMed1986

Usefulness of radionuclide angiocardiography in predicting stenotic mitral orifice area.

Fifteen patients with pure mitral stenosis (MS) underwent high-temporal-resolution radionuclide angiocardiography for calculation of the ratio of peak left ventricular (LV) filling rate divided by mean LV filling rate (filling ratio). Whereas LV filling normally occurs in 3 phases, in MS it is more uniform. Thus, in 13 patients the filling ratio was below the normal range of 2.21 to 2.88 (p less than 0.001). In 11 patients in atrial fibrillation, filling ratio divided by mean cardiac cycle length and by LV ejection fraction provided good correlation (r = 0.85) with modified Gorlin formula derived mitral area and excellent correlation with echocardiographic mitral area (r = 0.95). Significant MS can be detected using radionuclide angiocardiography to calculate filling ratio. In the absence of the confounding influence of atrial systole calculation of 0.14 (filling ratio divided by cardiac cycle length divided by LV ejection fraction) + 0.40 cm2 enables accurate prediction of mitral area (+/- 4%). Our data support the contention that the modified Gorlin formula, based on steady-state hemodynamics, provides less certain estimates of mitral area for patients with MS and atrial fibrillation, in whom echocardiography and radionuclide angiocardiography may be more accurate.

Adult↗
PubMed1990

Cardiac evaluation of candidates for kidney transplantation: value of exercise radionuclide angiocardiography.

In view of the high incidence and mortality of coronary artery disease (CAD) in patients with kidney transplantation, a systematic cardiac evaluation was prospectively performed in 103 uraemic patients eligible for transplantation. After clinical examination, 28 patients with symptoms of CAD or diabetes mellitus were referred directly for coronary angiography, whereas the remaining 75 patients had rest and exercise radionuclide angiocardiography for evaluation of possible asymptomatic CAD. Among them, left ventricular ejection fraction was below 40% at rest or fell during exercise by at least 5 EF% in 12 patients; coronary angiography in nine showed CAD in four and hypertensive heart disease in five. In the remaining 63 (of 75) patients without severe resting left ventricular dysfunction or exercise ischaemia, the follow-up of 28 +/- 7 months revealed no clinical manifestation of CAD. Overall incidence of CAD in symptomatic and asymptomatic patients during a follow-up of 27 months after cardiac evaluation was 20 and 25% in nondiabetic and diabetic candidates for kidney transplantation, respectively (P = n.s.). Thus, clinical examination combined with exercise radionuclide angiocardiography in patients without signs or symptoms of heart disease had a high predictive accuracy for presence or absence of late manifestations of CAD. Exercise radionuclide angiocardiography is therefore a useful method for screening kidney transplantation candidates for asymptomatic CAD.

Adult↗