InternationalJournalof CardiacImaging 7: 73-78, 1991.
© 1991 Kluwer AcademicPublishers. Printedin the Netherlands.
Quantitative regional curvature analysis: validation in animals of a method
for assessing regional ventricular remodelling in ischemic heart disease
G.B. John Mancini & Mark J. McGillem
Department of Internal Medicine, University of Michigan Medical School, Veterans Administration and
University of Michigan Medical Centers, Ann Arbor, Michigan, USA
Accepted30 July 1991
Key words: shape analysis, regional function, wall motion, wall thickening, ventricular function, ischemia,
coronary disease, remodelling
Abstract
Recent studies show the impact of left ventricular shape and remodelling on patient prognosis. This
mandates the development of quantitative methods for measuring shape. Quantitative regional curvature
analysis (QRCA) was developed to quantitate shape on a regional basis so that measurements would not be
constrained to assessment of only global shape and would, therefore be applicable to ischemic heart disease.
To validate QRCA, eleven dogs were instrumented with coronary occluders and radiopaque markers on the
epicardium and endocardium to provide fiducial points for calculation of shape, motion and thickening.
These parameters were measured in the anterior and inferior walls, at rest, during left anterior descending
occlusion and finally during circumflex occlusion. QRCA showed increased curvature (increased globular-
it),) in each wall when thickening and motion deteriorated during occlusion. The most marked shape changes
occurred in the inferior wall whereas the most marked deterioration of function was detected by wall
thickening measurements of the anterior wall. Thus, QRCA detects regional ventricular shape disorders
coincident with regional dysfunction induced by ischemia. These changes show regional heterogeneity and
demonstrate the potential importance of this measurement as opposed to simple, global measures of shape.
QRCA is, therefore, suitable for monitoring acute changes of shape that occur during acute ischemia.
Introduction
Shape and remodelling are increasingly being rec-
ognized as important parameters in the assessment
of ventricular function [1]. Quantitative Regional
Curvature Analysis (QRCA) was specifically de-
veloped to provide quantitative measures of these
important attributes and processes that character-
ize the ventricular response to injury [2-7]. More-
over, it was developed to allow measurements of
ventricular shape on a regional basis that are inde-
pendent of ventrictdar size, or volume. QRCA has
been applied to clinical studies of contrast ventricu-
lography which have shown that parameters of
shape correlate with measures of regional wall mo-
tion [4-5]. However, due to uncertainties in the
location of the endocardial wall in contrast ventri-
culographic studies, these applications cannot be
considered suitable for validating the method or
determining whether shape changes parallel acute
deterioration of regional function. Therefore, the
purpose of the study was to validate QRCA in
animals with implanted, lead markers that provide
a fiducial reference for ventricular wall motion and
wall thickening measurements and to determine if
conformational changes measured by QRCA par-