We traced left ventricular contours, frame-by-frame throughout systole and diastole, of normal sinus beats from 30 degrees right anterior oblique ventriculograms from 32 normal patients. We separated both systole and diastole into 19 equal time intervals each and calculated regional lengths (R), normalized by both end-diastole length and relative time interval (T) in systole and diastole and diastole, for the middle inferior wall, distal inferior wall, apex, distal anterior wall, middle anterior wall, and proximal anterior wall. We also computed the relative velocities of R, delta R/ delta T, over each quarter of systole and diastole. Comparing systole with diastole, we found significant differences between paired values of R at all regions except the distal inferior wall, but these differences were not the same between regions. Between regions, mean R and delta R/ delta T values were significantly different as early as the first quarter of systole. Within a region, there were significant differences between mean R and delta R/ delta T values over intervals as short as one-fourth of systole or diastole. Thus, there is no homogeneity between regions in normal wall motion in both systole and diastole. This normal lack of homogeneity has important clinical implications for identifying abnormal wall motion in individual patients from ventriculographic measurements, and for using the information present in the diastole portion of the ventriculogram to characterize normal segmental function.
This study confirms the accuracy and reliability of sonographic assessment of renal dimensions when meticulous scanning techniques are employed. Sonographic renal dimensions are smaller than those obtained by radiography, since there is neither the geometric magnification nor the change in size related to an osmotic diuresis from iodinated contrast material. Sonographically, with patients in the prone position, the mean right renal length was 10.74 cm (+/- 1.35 SD) and the mean left renal length was 11.10 cm (+/- 1.15 SD). A prospective sample demonstrated the mean depth (ventral-dorsal dimension) to be approximately 4.5 cm when the transducer was angulated for the lie of the kidney.
The sequence for the onset of segmental contraction of the left ventricle was studied in 25 normal patients by analyzing sequential frames obtained at 16.7-msec intervals of right anterior oblique (RAO) ventriculograms by two independent methods. In the first method, we compared the times of onset of contraction of the hemidiameters associated with each of 54 segments with time of onset of contraction of the average of all the hemidiameters for the ventricular contour. In the second method we used a radial coordinate system and determined relative phase relationships by plotting the motion of each of 54 segments against the average motion of all segments. The resulting pattern showed that, on the average, the midregion of the inferior wall began to contract 25 msec before the apex and the midregion of the anterior wall began contraction 18 msec before the apex. In 12 of 25 patients the interior and anterior walls both began to contrast before the apex. In only one of 25 patients did the apex begin to contract first. This sequences of contraction corresponds to the reported sequence of electrical activation for normal human left ventricles.
'/%3e%3c/defs%3e%3cpath fill='%23012169' d='M0 0h10080v5040H0z'/%3e%3cpath stroke='%23fff' stroke-width='.6' d='m0 0 6 3m0-3L0 3' clip-path='url(%23b)' transform='scale(840)'/%3e%3cpath stroke='%23e4002b' stroke-width='.4' d='m0 0 6 3m0-3L0 3' clip-path='url(%23c)' transform='scale(840)'/%3e%3cpath stroke='%23fff' stroke-width='840' d='M2520 0v2520M0 1260h5040'/%3e%3cpath stroke='%23e4002b' stroke-width='504' d='M2520 0v2520M0 1260h5040'/%3e%3cg fill='%23fff'%3e%3cuse xlink:href='%23d' x='2520' y='3780'/%3e%3cuse xlink:href='%23a' x='7560' y='4200'/%3e%3cuse xlink:href='%23a' x='6300' y='2205'/%3e%3cuse xlink:href='%23a' x='7560' y='840'/%3e%3cuse xlink:href='%23a' x='8680' y='1869'/%3e%3cuse xlink:href='%23e' x='8064' y='2730'/%3e%3c/g%3e%3c/svg%3e)