APPLICATION OF FIBEROPTIC DYE-DILUTION TECHNIC TO ASSESSMENT OF MYOCARDIAL FUNCTION .I. DESCRIPTION OF TECHNIC AND RESULTS IN 100 PATIENTS WITH CONGENITAL OR ACQUIRED HEART DISEASE

Indicator-dilution curves were recorded by means of the fiberoptic hemoreflection system in 100 patients. The technic involves left ventricular injection of indocyanine green and central aortic sampling. Stroke volume, ejection fraction, end-diastolic and end-systolic volumes were all derived from the same density curve. Multiple curves were recorded in all instances. There were 19 patients with valvar aortic stenosis, 15 with idiopathic hypertrophic subaortic stenosis, 15 with aortic regurgitation, 9 with mitral regurgitation and 6 with chronic myocarditis of varying severity. Eight patients had a ventricular septal defect, 9 an atrial septal defect and 6 had valvar pulmonic stenosis. The remainder of the patients had diverse disorders. The results were expressed as milliliters per kilogram of body weight and as milliliters per square meter of body surface area. Since there was close similarity among the data describing the 40 patients with obstructive lesions, their data were collected into a group. Stroke volume was 1.5 ml./kg. body weight, ± 0.42; ejection fraction was 0.577, S.D. ± 0.08; end-diastolic volume 2.7 ml./kg. body weight, S.D. ± 0.76; end-systolic volume was 1.2 ml./kg. body weight, S.D. ± 0.49. These data correspond closely to those of normal subjects reported by other investigators. In contrast, in regurgitant lesions, end-diastolic volume was high, stroke volume normal and ejection fraction depressed, reflecting the severity of the regurgitation. Still lower ejection fractions and higher end-diastolic volumes were found in myocarditis. Conversely, high ejection fraction and high end-diastolic volume with high stroke volume were seen in ventricular septal defects. While a linear correlation between end-diastolic volume and stroke volume existed in the group with obstructive lesions, no such clear relation could be determined in the remaining lesions. The variability in the interrelation of these factors is stressed, as well as the need for their determination in the proper assessment of the total hemodynamic state of the individual lesion. © 1969.