Left ventricular diastolic filling in patients with left ventricular dysfunction

Abstract

The pattern of abnormal left ventricular diastolic filling and its specificity in coronary disease patients with severe left ventricular dysfunction has received little attention. We evaluated the left ventricular diastolic filling curve derived from gated blood pool scans in 21 normals, 61 coronary disease patients with ejection fractions ⩽30%, and 51 congestive cardiomyopathy patients with ejection fraction ⩽30%. The peak filling rate (PFR), peak ejection rate (PER), PER PER and the % stroke volume filled at 1 3 of diastole ( %SV- 1 3 DT ) and at the end of the rapid filling period (%SV-RFP) were determined for each group. The PFR and PER were reduced in both coronary disease and congestive cardiomyopathy groups. The PFR PER was increased in the coronary disease group (1.19 ± 0.28) and congestive cardiomyopathy group (1.21 ± 0.32) as compared to normals (0.93 ± 0.20, P < 0.001). A greater %SV- 1 3 DT and %SV-RFP were noted in both coronary disease and congestive cardiomyopathy groups. Coronary disease and congestive cardiomyopathy patients with a mean pulmonary capillary pressure (PCP) ⩾ 18 mm Hg had a greater PFR PER , %SV- 1 3 DT , and %SV-RFP than patients with a PCP < 18 mm Hg. An abnormal and nonspecific pattern of left ventricular diastolic filling is present in both coronary disease and congestive cardiomyopathy patients and is characterized by an increased FER PER , a greater %SV- 1 3 DT , and a greater %SV-RFP. This pattern may be related to elevated PCPs.