Heart; Functional Disturbance Clinical Trial
Official title:
Comparison of Very Low Contrast Volume Hand Injected Ventriculography to Standard Contrast Volume Power Injected Left Ventriculography From the Radial Artery Approach for Estimation of Left Ventricular Ejection Fraction.
The purpose of the study is to directly compare two methods of evaluating heart function at the time of your angiogram. In both methods contrast dye is injected into the main heart chamber during the angiogram while x-ray images are taken. One method uses an automatic power injector to deliver the normal volume of contrast; the other method uses hand injection of very low volume of contrast into the main heart chamber. It is hypothesized that hand injection will prove to be an accurate method to estimate ejection fraction (EF) at the time of radial coronary angiography when compared directly to Power LV.
Left ventriculography is a routine and accurate method of evaluating left ventricular
ejection fraction (EF) at the time of coronary angiography. Power injected left
ventriculography (Power LV) using standard volume (36 ml over 3 seconds) of contrast through
a 5 Fr. angled pigtail catheter in the left ventricle is currently a routine clinical
practice during left heart catheterization via the radial artery. With coronary angiography
from the radial approach increasing in popularity there is a growing interest in hand
injected left ventriculography (Hand LV) using a very low volume (8ml) of contrast through a
5 Fr. radial angiographic catheter. Potential benefits of this method include reduced
contrast load, reduced procedure time and overall reduction in cost (less catheters used per
procedure) as the procedure can be completed using a single diagnostic catheter. Potential
limitations of this method include reduced opacification of the left ventricle and decreased
number of cardiac cycles available to estimate EF. It is currently unknown if Hand LV is
accurate in estimating EF when compared to the standard Power LV.
Objective: The primary objective of this study is to directly compare the accuracy of the
very low volume Hand LV to the standard volume Power LV in estimating EF.
Methods: This study will be conducted in an outpatient setting. The subjects enrolled in
this study will be adults referred for radial coronary angiography with left
ventriculography for clinical indications. Subjects will undergo both Hand LV and Power LV
at the time of angiography. EF for both Hand LV and Power LV will be estimated for each
subject in a blinded fashion by 2 independent experienced cardiologists. Additionally,
quantitative EF measurements will be made using integrated standard computer software for
both the Power LV and the Hand LV. Each patient will serve as their own control.
Research Design: This is a prospective single center study designed to evaluate clinical
techniques for diagnostic accuracy.
Clinical Relationships: It is anticipated that Hand LV will be and accurate method to
estimate EF when compared to Power LV. (e.g. within a 5% difference is clinically is
considered within inter and intra-individual variability.) This knowledge will allow
clinicians to confidently perform Hand LV at the time of radial coronary angiography to
estimate EF, reducing procedure time, contrast load and overall cost of the procedure.
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Observational Model: Case-Only, Time Perspective: Prospective
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