Usefulness of coronary angiography for assessing left ventricular systolic function

Abstract

In previous echocardiographic studies, a correlation between ejection fraction of the left ventricle and change in the movement of mitral annular ring was found. In the light of these studies we planned this study to investigate the relationship between systolic shortening (SS) and percent of systolic shortening (PSS), calculated from long axis frame in coronary angiography and left ventricular systolic functions. One hundred and thirty eight patients (40 women and 98 men; mean age 58 ± 10 years) who had been referred for coronary angiography and left ventriculography were included in the study. Ejection fraction (EF) was calculated from left ventriculography obtained from 30° right anterior oblique projection. Distance from lower border of the ostium of left coronary artery to the most apical border of left anterior descending (LAD) artery was measured at end-systole (ES) and end-diastole (ED) using coronary angiography obtained from the same projection. SS as ED-ES and PSS as SS/ED were calculated. Correlation of SS and PSS with EF was calculated (EF=13.7+4.9 × SS, r=0.91 and EF=14.2+6.5 × PSS, r=0.90). SS <7 mm and PSS <6% indicated that left ventricle EF was less than 50%, with a sensitivity, specificity and diagnostic accuracy 83%, 100%, 95%; 95%, 86% and 88%, respectively. In conclusion, SS and PSS calculated from coronary angiography have high correlation with left ventricular EF. Therefore, left ventriculography can be omitted in selected patients undergoing coronary angiography if it is not necessary to define the anatomic structure of left ventricle.