Relation of regional asynchrony to global left ventricular systolic and diastolic function in patients with angina pectoris without previous myocardial infarction.

Abstract

To assess left ventricular (LV) systolic and diastolic function globally and regionally and to study the relationship between regional asynchrony and global LV function in patients with stable effort angina pectoris (AP) without previous myocardial infarction, we conducted a resting gated radionuclide ventriculographic study in 15 control subjects (N group) and 22 AP patients with isolated disease of the left anterior descending coronary artery (LAD). In nine of these 22 AP patients, LV systolic and diastolic function before surgical revascularization (Aorto-Coronary Bypass) were compared with those after surgical revascularization. A computer program subdivided the image of the LV into four regions (septal, basal, lateral and apical) by our previously reported method. The time-activity and first-derivative curves of the global LV and three regions (septal, lateral, apical; the basal region was not computed) LV were computed. In the global LV, the peak filling rate (PFR) normalized to LV end-diastolic volume (EDV) and the ratio of increment of filling volume at 100 msec from global end-systole (ES) to the EDV (%EFV), which was correlated with the time constant of LV pressure decay during isovolumic relaxation, decreased (p less than 0.01, p less than 0.001, respectively) and time to PFR (time interval from global ES to PFR) was greater (p less than 0.001) in the AP group than that in the N group. However, in the AP group, the ejection fraction (EF), normalized peak ejection rate (PFR) and %1/3SV, which was defined as the percent stroke volume ejected during the first third of the global LV ejection phase, were not different from these in the N group.(ABSTRACT TRUNCATED AT 250 WORDS)