Abnormalities of Dynamic Ventricular Shape Change in Patients With Aortic and Mitral Valvular Regurgitation: Assessment by Fourier Shape Analysis and Global Geometric Indexes

• Published in: Circulation research Vol. 62; no. 1; pp. 127 - 138
• Main Authors: Kass, David A, Traill, Thomas A, Keating, Mark, Altieri, Pablo I, Maughan, W Lowell
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Heart Association, Inc 01.01.1988; Lippincott
• Subjects: Algorithms; Aortic Valve Insufficiency - pathology; Biological and medical sciences; Cardiology. Vascular system; Endocardial and cardiac valvular diseases; Fourier Analysis; Heart; Heart Ventricles - pathology; Humans; Medical sciences; Methods; Mitral Valve Insufficiency - pathology; Myocardium - pathology; Systole; Heart; Human; Left ventriculography; Radiodiagnosis; Cardiac valvular disease; Mitral regurgitation; Harmonic analysis; Cardiovascular disease; Hemodynamics; Aortic regurgitation; Morphometry; Left ventricle
• ISSN: 0009-7330; 1524-4571
• DOI: 10.1161/01.RES.62.1.127

The normal cardiac cycle is associated with dynamic changes in left ventricular shape, which can be disturbed in disease states. To assess the influences of diastolic volume, percent ejected volume, and abnormalities of acute or chronic systolic loading on general and detailed chamber geometry, we studied dynamic shape change recorded by x-ray contrast ventriculography in both normal patients and those with aortic (AR) or mitral (MR) valve regurgitation. While both lesions increased diastolic volume, the character of load throughout ejection differed markedly. Detailed cavity geometry was assessed by a Fourier analysis technique and general shape by eccentricity and circularity indexes. Normal hearts showed increased systolic elongation by all indexes. AR patients displayed a similar rise in eccentricity during ejection; however, the extent of shape change when measured by Fourier and circular indexes was reduced. In contrast, MR patients displayed enhanced systolic shape hange, particularly in chamber elongation. Neither simple eccentricity or circular indexes adequately differentiated these shape abnormalities, whereas detailed Fourier geometric analysis precisely characterized the abnormalities of shape change in these two diseases. Relations between the extent of shape change and ejected volume for each patient group revealed significantly more systolic deformation with a different shape versus volume relation for the MR hearts as compared with AR and controls. Thus, while dynamic left ventricular shape is certainly influenced by the extent of volume change, it also varies independently from volume related to the specific nature of loading during ejection.