Quantitative cineangiographic analysis of ventricular volume and mass in patients with single ventricle: Relation to ventricular morphologies

Abstract

With the use of biplane selective ventriculography, the ventricular volume, ejection fraction, and ventricular mass were evaluated in 28 patients with a single ventricle, and those with the left ventricular type (LV type, 12 patients) and right ventricular type (RV type, 16 patients) were compared. There were no significant differences in terms of age, hemoglobin, systemic oxygen saturation, or pulmonary-to-systemic flow ratio in the two groups. No patients with atrioventricular valve regurgitation were included. The ventricular cavity volume was calculated by the area-length method. The ventricular mass volume was determined as the shell volume created by subtracting the ventricular cavity volume from the total ventricular volume calculated by adding the free wall thickness to the chamber dimensions. The ventricular mass volume was converted to mass by multiplying by the gravity of the heart muscle. There was no significant difference between patients with the LV type and RV type of single ventricle with respect to the end-diastolic ventricular volume (188 ± 53 and 179 ± 61 ml/m2 in LV and RV types, respectively), end-systolic volume (88 ± 31 and 84 ± 27 ml/m2), or ejection fraction (0.54 ± 0.06 and 0.52 ± 0.06). The following four indexes of the ventricular mass were significantly (p < .01) but no correlation was seen in those with RV type. These results suggest that there is inadequate ventricular hypertrophy (insufficient ventricular mass to ventricular volume) in patients with the RV type of single ventricle compared with that in those with the LV type and this may lead to abnormal contractile state and poor adaptation of ventricular function in patients with the RV type of single ventricle.