Aneurysmectomy prognosticators by equilibrium multi-gated cardiac blood pool scintigraphy.

Abstract

Non-invasive assessment of left ventricular aneurysm (LVA) resection prognosticators was obtained in 13 multigated cardiac blood pool scintigrams by applying Fourier analysis to identify regions of interest. Results were compared to contrast ventriculograms performed at recent cardiac catheterization. Excellent correlation of the contractile section ejection fraction (CSEF) was found between the two techniques, r = .92 (P less than or equal to .0001). The CSEF correlated inversely with the left ventricular end diastolic pressure (LVEDP), r = .83 (P less than or equal to .0004), implying that LVEDP is not an independent prognosticator. The relative LVA size expressed as a fraction of the left ventricle in end diastole (LVASF) correlated less strongly with LVASF derived from contrast ventriculography, r = .67 (P = .012). This was probably due to additive inherent errors in contrast ventriculography geometric assumptions. Paradoxical stroke steal fraction (PSSF) defined as the reverse stroke lost in the LVA divided by the left ventricular forward stroke, was calculated from subtraction images. We propose a resectability score utilizing the product of the scintigraphically derived CSEF X LVASF X PSSF X 1,000 to obtain non-invasive pre-operative prognostication of LVA resection and post-operative evaluation.