Changes in the left ventricular (LV) function during direct ventriculography (contrast medium injected into LV cavity) and during intravenous left ventriculography (contrast medium injected into right atrium) were assessed in 22 normal subjects. During angiography the left ventricular pressure was continuously recorded by a microtip manometer catheter. LV images and pressure curves were analysed by a computer analysis system. The forceful intraventricular injection of contrast medium during the direct ventriculogram resulted in significant changes in the LV diastolic function, and increased LV pressure and LV working parameters. Mechanical efficiency of the LV contraction decreased. Acute volume overload of the left ventricle appears to be the main limitation of this method. To overcome this limitation, we recommend the use of intravenous biventriculography with simultaneous recording of LV pressure, instead of direct ventriculography. This modification with subsequent frame to frame analysis of the study results may be used successfully in clinical research trials.
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