Cineangiographic evaluation of diastolic properties of the left ventricle in man.

Abstract

Diastolic properties of the left ventricle were evaluated cineangiographically in 110 patients with various heart diseases (19 normal cases, 13 mitral stenosis, 19 left ventricular volume overload, 18 coronary artery diseases without myocardial infarction, 27 myocardial infarction, 6 hypertrophic cardiomyopathy, 5 congestive cardiomyopathy and 3 chronic constrictive pericarditis). Early diastolic ventricular filling was assessed by diastolic maximal circumferential relaxation velocity (maxVcf), diastolic maximal dV/dt, volume change during early 1/3 of ventricular filling (V1/3), rapid filling time and isovolumic relaxation time; myocardial stiffness constant K was calculated at end-diastole. Increase in myocardial stiffness constant was not necessarily associated with abnormal indices measured during the early diastolic period but well correlate with isovolumic relaxation time. During the isovolumic relaxation period, the affected left ventricular segments where myocardial infarction or myocardial hypertrophy existed, showed reduced and delayed relaxation resulting in a total increase in the isovolumic relaxation period. Calcium antagonist was effective in improving the delayed relaxation in patients with left ventricular hypertrophy, suggesting a role of calcium on delayed myocardial relaxation in the hypertrophied heart.