functiion in man

All traditional techniques of regional ventricular function analysis depend upon one or more assumptlons about coordinate, reference, or indexing systems, Waltzed ventricular geometry, and the uniformity of vent&Mar contraction. Therefore, a method of shape analy8k was developed that allows the quantitation of regional curvature and is independent of the aerrumptions outlined. This was implemented on a commercial Image pfoceostng unit and applied to silhouettes of -degree right anterior oblique left ventricutogrems. Three groups with abnormal wall motkm (snterior abnormality, n = 23; inferior abnormality, n = 23; anterior and Inferior abnormatittes, n = 22) were anatyxed and compared to a group with normal regional function (n = 22). Relatively few signfficant quantitatfve curvature dffferencea were noted at end diastole among the groups. These few abnormattties described a sttght increabe In curvature or globularity of the anterior and inferior welts. More marked and extensive aberrations were detected at end systole. The group with anterior waM motton disturbance8 showed four distinct areas of curvature abnormality. Excessive curvature was present on either side of the apex (anterior and inferoapical regions) and apical curvature was less than normal. The fourth region was in the inferior zone, which showed curvature values that were kres than normal, suggesting increased inward motion contrafateral to the anterior abnormallty. The group wtth inferior wall motion abnormalities also showed excessive end-systottc curvature on either side of the apex (diaphragmatic and anteroapical zones) and deficient curvature at the apex. A combination of these regional morpholegic abnormalities was noted in the group with both anterior and inferior dysfunction. Regional shape change (end-diastolic minus end-systolic curvature) largely reflected the same abnormalles as the analysts of end-systolic curvature alone. In conclusion, shape abnormatlties secondary to regional dysfunction can be quantitated on a segmental basis. This form of analysis provides a conceptually different approach to the quantitation of regional ventricular function that is divorced from the assumptions mandated by tradfttonat techniques. (Am HEART J 1987; 113:326.)