Regional and temporal nonuniformity of shape and wall movement in the normal left ventricle

Asymmetry of left ventricular (LV) shape and asynchrony of regional LV move ment have been described in the normal human heart, but never correlated to each other. In 16 normal subjects, right anterior oblique ventriculography was used to obtain volumes, regional wall motion (centerline method) and c urvature (windowed Fourier series approximation of contours) over the entir e cardiac cycle. The apex had the greatest curvature, while the posterior w all had a negative end-diastolic curvature that decreased further at early- systole and became positive at end-systole. The anterior region had the gre atest and the anteroapical region the least fractional shortening. Asynchro ny was evident as a delayed contraction of the infero- and anteroapical reg ions, and as a greater rate of late-systolic shortening of the anterior wal l than that of the apex. Shape changes and shortening were dyssynchronous i n the apical regions where the greatest changes occurred at early diastole. Temporal and regional nonuniformity of shape and movement exists in normal subjects. Dyssynchrony between shape and regional contraction of the apica l regions deserves further studies.