Temporal pattern of regional left ventricular wall motion in patients with segmental early relaxation

Abstract

AbstractThe purpose of this investigation was to describe the temporal pattern of regional left ventricular (LV) wall motion in patients with segmental early relaxation (SER). Segmental early relaxation was demonstrated angiographically in seven patients undergoing diagnostic cardiac catheterization because of chest pain. In all patients, early relaxation of only the anterolateral wall was observed. The temporal pattern of regional wall motion was assessed from ventriculograms, obtained in the right anterior oblique projection, by measuring the lengths of the anterolateral minor axis chord and the corresponding diaphragmatic minor axis chord. The onset of lengthening of the anterolateral chord preceded that of the diaphragmatic chord by 110 ± 10 msec. Maximal shortening of the anterolateral chord during systole was 43 ± 4% and was coincident with a 32 ± 4% shortening of the diaphragmatic chord. During early relaxation, shortening of the anterolateral chord diminished to 17 ± 4% (P <.01); and was coincident with a 35 ± 4% shortening of the diaphragmatic chord (P <.05). Early relaxation of the anterolateral wall was followed by a transient augmentation of shortening of the anterolateral chord to 29 ± 3% (P <.001), whereas shortening of the diaphragmatic chord diminished to 32 ± 4%. Subsequently both chords returned to their initial end‐diastolic lengths. These preliminary observations indicate that early lengthening of the anterolateral segment is followed by a transient rebound of shortening which was only present in the segment that manifested early relaxation.