Left ventricular end-diastolic pressure before and after coronary arteriography: The value of coronary arteriography as a stress test

Abstract

A study of the left ventricular hemodynamics of 95 subjects in whom coronary cinearteriography was performed demonstrated statistical differences among the mean resting left ventricular end-diastolic pressure of normal subjects, patients with cardiomyopathy, patients with coronary artery disease and patients with coronary artery disease and aneurysm. These values were lowest in the normal subjects ( x ̄ = 8.1 mm Hg ) and in those with hypertrophic cardiomyopathy ( x ̄ = 9.7 mm Hg ), higher in the group with uncomplicated coronary artery disease ( x ̄ = 10.2 mm Hg ) and highest in patients with coronary artery disease and aneurysm ( x ̄ = 12 mm Hg ). The mean resting values appeared to be directly related to the degree of disease of the left ventricle. The largest increase of the left ventricular end-diastolic pressure after coronary arteriography, that is, up to 175 percent of the resting value, was recorded in patients with coronary artery disease ( x ̄ = 17.8 mm Hg ) and in the group with left ventricular aneurysm ( x ̄ = 18.6 mm Hg ). Lesser increments were detected in the control subjects ( x ̄ = 12.6 mm Hg ) and in patients with hypertrophic cardiomyopathy ( x ̄ = 11 mm Hg ). The correlation with left cineventriculography clearly indicates that the greatest increase in left ventricular end-diastolic pressure after selective coronary arteriography occurred in those patients who had the more extensive and severe degrees of left ventricular involvement. The behavior of the left ventricular end-diastolic pressure after selective coronary arteriography may be utilized as an additional and useful test in evaluating the functional state of the left ventricle.