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Assessment of Regional Wall Motion of the Left Ventricle in Children with Congenital Heart Disease

Journal of the Korean Pediatric Society 1999;42(6):807-816.
Published online June 15, 1999.
Assessment of Regional Wall Motion of the Left Ventricle in Children with Congenital Heart Disease
Chang Hee Han1, Jun Ho Huh1, Un Seok Nho2, Byung Ho Choi1, Myung Chul Hyun1, Sang Bum Lee1
1Department of Pediatrics, Kyungpook National University, College of Medicine, Taegu, Korea
2Department of Pediatrics, Masan Samsung Hospital, Masan, Korea
선천성 심질환 환아에서 좌심실 국소운동의 평가
한창희1, 허준호1, 노은석2, 최병호1, 현명철1, 이상범1
1경북대학교 의과대학 소아과학교실
2마산삼성병원 소아과
Correspondence: 
Sang Bum Lee, Email: 1
Abstract
Purpose
: To assess wall motion of the left ventricle in the various forms of congenital heart disease and to select appropriate methods by which to gauge left ventricular wall motion.
Methods
: We evaluated left ventricular function, including volume, global ejection fraction, and regional wall motion(Centerline method, Local Ejection Fraction, Curved Perimeter method and Radial method). The evaluation was done on review mode of 30-degree elongated right anterior oblique projection of left ventriculogram by using cardiac analysis program of the DXC Hiline Digital System(GER, USA) in 53 pediatric patients undergoing diagnostic(or therapeutic) cardiac catheterization from June 1995 to July 1996 at Kyung-pook National University Hospital.
Results
: Cardiac indices calculated by Dodge's and Simpson's methods were 5.76¡¾2.13 L/min/ m2, 5.86¡¾2.31 L/min/m2 respectively with significant correlation to each other(r=0.99, P<0.01). Global ejection fractions using both methods were 69.81¡¾8.33%, and 69.69¡¾8.20%, respectively (r=0.99, P<0.01). After dividing the left ventricular outline contour into five regions such as posterobasal, diaphragmatic, apical, anterolateral and anterobasal portions, all four models could ascertain regional wall motion abnormalities well(P<0.01). And among them, the Centerline method and the Curved Perimeter method correlated well in assessing wall motion(for each portion r=0.67, 0.84, 0.94, 0.91 and 0.61 respectively, P<0.01).
Conclusion
: In conclusion, we confirmed regional wall motion abnormalities in the various forms of congenital heart disease in spite of normal global ejection fractions, showing that the Centerline and Curved Perimeter methods are preferable methods in the assessment of wall motion in patiens with congenital heart disease.
Key Words: Regional wall motion, Left ventricle, Congenital heart disease, Geometric models


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