Left ventricular systolic circular index: An echocardiographic measure of transseptal pressure ratio

Michael A. Portman, Abdul M. Bhat, Mark H. Cohen, Mark D. Jacobstein

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Abstract

An echocardiographic index of left ventricular (LV) short axis circularity can be defined by the equation: left ventricular systolic circularity index (LVSCI) = 4 π(LV area) × 100/(LV perimeter2). This index was measured from two-dimensional echocardiograms in 98 children (ages 1 day to 19 years) with congenital heart disease, and results were compared to right ventricular/left ventricular peak systolic pressure ratios (RVP/LVP) determined at cardiac catheterization. LVSCI was also computed in 50 children without cardiovascular or pulmonary disease to define the normal range. A short axis image of the left ventricle at the level of the papillary muscles was obtained from the left parasternal position. Area and perimeter were determined by computer pianimetry of the LV endocardium at end systole. LVSCI was measured from three consecutive beats and averaged. In the normal group all values of LVSCI exceeded 93% (mean 96%). In the group with congenital heart disease RVP/LVP correlated exponentially with LVSCI: RVP LVP = e2.6 - 0.04 LVSCI; with r = 0.88, SEE = 0.39, and p < 0.001. If patients with suprasystemic right ventricular pressures (RVP/LVP > 1.2) are excluded, there is a linear correlation between RVP/LVP and LVSCI: RVP LVP = 2.3 - 0.021 LVSCI; with r = 0.80, SEE = 0.14, and p < 0.001. LVSCI could distinguish between patients with normal, mildly elevated, moderately elevated, and severely elevated RVP/LVP. We conclude that LVSCI is a readily determined parameter that is independent of age or body size and predicts RVP/LVP in children with congenital heart disease.

Original languageEnglish (US)
Pages (from-to)1178-1182
Number of pages5
JournalAmerican Heart Journal
Volume114
Issue number5
DOIs
StatePublished - Nov 1987

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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