Quantitative contrast angiography for assessment of ventricular performance in heart disease.

Contrast angiography provides much information about ventricular and valvular size and function. This review describes the calculation of left ventricular chamber volume and wall thickness and the derivation of ejection fraction, cardiac output, mass and wall tension and stress. In patients with valvular regurgitation, valve orifice area can be calculated by using the angiographic output and regurgitant flow determined by comparing the angiographic output with the cardiac output measured using Fick or indicator-dilution techniques. By analyzing ventricular volume in conjunction with pressure, it is possible to assess pressure-volume work, compliance and contractility. Regional wall motion can be measured from the change in ventricular contour with time. When applied clinically, these methods and measurements have been used to determine the hemodynamic characteristics of the compensated and decompensated left ventricle in valvular and coronary heart disease. The information derived from quantifying information in angiographic images contributes to patient diagnosis, assessment of prognosis and evaluation of therapy, and has added to our knowledge concerning the pathophysiology of heart disease.