VENTRICULAR VOLUMES EJECTION FRACTION MASS WALL STRESS REGIONAL WALL MOTION

VENTRICULAR VOLUMESEJECTION FRACTION

MASSWALL STRESS

REGIONAL WALL MOTION

Márcio Alves de Urzêda, M.D.; MSc

VOLUMES(Technical considerations)

• Cine film: – 15-60 fps;

• Radiographic contrast:– 7-15mL/s and 30-50mL.

• Sites:– Left ventricle;– Left atrium (trans-septal technique);– Severe aortic insufficiency:

• Aortic root.

Ventricular volumes

• Silhouette must be traced:– Marged visible

contrast;– Include

trabeculations and papillary muscles.

Ventricular volumes

• Approximated by an ellipsoid;• Regression equations correct the

overestimation.• Biplane projection to • determinate M and N.

Ventricular volumes

• Area-length method (Dodge);• Biplane oblique (RAO/LAO):

Ventricular volumes

Single plane formula:

•AP or RAO;•Left ventricular shape is a spheroid (ellipsoid wich two minor axes are equal).

VENTRICULAR VOLUMES

• Volume correction:– Overestimation by papillary muscles and

trabeculaes.

• Regression equations

EJECTION FRACTIONREGURGITANT FRACTION

• EF= (EDV-ESV) EDV

• RF= SV angiographic – ESV forward) SV angiographic

Left Ventricular Mass

• Is assumed that wall thickness is uniform

Wall Stress• σ = PR 2h

• Meridional, radial and circunferencial.

A and B: semi-axis

REGIONAL LEFT VENTRICULAR WALL MOTION

• Akinesis, dyskinesis, hypokinesis and hyperkinesis.