Comparison of coronary arteriographic and left ventriculographic findings in patients with single, double, and triple vessel disease and angina pectoris.

Abstract

The distribution and severity of coronary artery disease and degree of left ventricular dysfunction are described in 500 patients with single (103), double (119), and triple (278) vessel disease and angina pectoris. The coronary arterial patterns were divided into right (360), mixed (89), and left (51) systems, depending upon the blood supply to the inferior surface of the left ventricle. The following relationships were noted: 1) Coronary arterial patterns of right, mixed, and left systems do not influence the presence, distribution, or severity of coronary arterial lesions among patients with single, double, and triple vessel disease and angina pectoris. 2) Analysis of the distribution of lesions among patients with single and double vessel disease reveals that the circumflex/obtuse marginal arteries contribute least of the three major coronary arteries to angina pectoris. 3) Lesions of 70-90% reduction in coronary arterial luminal diameter are the most common, and 90-99% lesions are the least common. The latter are least stable among patients with both coronary artery disease and angina pectoris. 4) Quantitatively there is progression of both coronary artery disease and left ventricular dysfunction as one moves from single to double and then to triple vessel disease. However, the pattern of coronary arterial lesions (50-70%, 70-90%, 90-99%, and 100% reduction of luminal diameter) and the pattern of left ventricular dyssynergy (hypokinesis, akinesis, and dyskinesis) are similar among the patients with single, double, and triple vessel disease and angina pectoris.