Comparison of low-volume versus standard-volume left ventriculography

Left ventriculography provides useful information about cardiac function, w all motion, and mitral regurgitation (MR). However, standard volumes of con trast agent frequently are associated with ventricular ectopy. This study c ompares the use of low-volume (Low-vol) ventriculography to standard volume (Std-vol) ventriculography, Left ventricular (LV) ejection fraction (EF), changes in LV end-diastolic pressure (LVEDP), the incidence of ectopy, and >2+ MR were prospectively determined from the random order use of standard (15 mL/ second for 3 sec) and low-volume (15 mL/sec for 1 sec) contrast age nts in 102 patients. Each patient served as his or her own control. Twenty- seven percent of the 204 ventriculograms were not interpretable due to ecto py. Ectopy greater than or equal to 3 beats was more common with Std-vol an giograms (41% vs. 14%, P < 0.001). Postinjection LVEDP increased from basel ine after both Std-vol and Low-vol injections (P <0.001). In patients for w hom both angiograms could be interpreted (n = 58), no differences were note d between planimetered EFs (Low-vol = 61 +/- 20% vs. Std-vol = 62 +/- 20%, with r = 0.87; P < 0.001). A Bland-Altman test of agreement indicated a mea n difference +/- 95% Cl = -2 +/- 19%. Low-volume ventriculography reduces c ontrast load and ectopy while providing similar estimates of EF compared wi th standard volumes. Published 2001 Wiley-Liss, Inc.(<dagger>).