Compared with echocardiography, left ventriculography during catheterization is considered to be:

• A. More accurate for measuring LV ejection fraction during catheterization.
• B. The same accuracy as echocardiography.
• C. Less accurate and not helpful.
• D. Cannot be used for ejection fraction assessment.

Answer: (A)

During catheterization, left ventriculography provides a direct, contrast-filled view of the left ventricular cavity with high temporal and spatial resolution, allowing precise delineation of the endocardial borders and straightforward calculation of volumes and ejection fraction. End-diastolic and end-systolic volumes can be measured from cine frames where the LV silhouette is well defined, giving a reproducible EF value from the same study.

Echocardiography, while noninvasive and widely used, depends on ultrasound windows and image quality and relies on visualizing borders that can be obscured or misinterpreted in some patients, leading to greater variability. The combination of clear LV silhouette with cine imaging in ventriculography often yields a more accurate EF estimate during the invasive study, even though it is an invasive procedure with its own risks.