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[Volume parameters of the right and left ventricles in coronary disease with and without myocardial infarct]
Insights
Coronary heart disease impacts left and right ventricle volumes and ejection fractions. Inferior wall infarction in the left ventricle uniquely impairs right ventricle contraction, suggesting reversible ischemic dysfunction.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Myocardial Infarction
Context:
- Coronary heart disease (CHD) affects ventricular function.
- Left ventricular damage localization influences hemodynamic parameters.
- Right ventricular (RV) function assessment in conjunction with left ventricular (LV) damage is crucial.
Purpose:
- To determine the volume parameters of both ventricles in patients with coronary heart disease based on the localization of left ventricular damage.
- To analyze the impact of anterior wall infarction (AWI) and inferior wall infarction (IWI) on left and right ventricular function.
Summary:
- Patients with coronary heart disease were categorized into four groups based on left ventricular damage.
- Anterior wall infarction (AWI) led to increased LV end-diastolic volume (EDV) and reduced ejection fraction (EF), with unchanged RV parameters.
- Inferior wall infarction (IWI), with or without AWI, resulted in increased EDV and decreased EF in both ventricles. Notably, IWI was associated with impaired RV contraction, exceeding scar extent, suggesting reversible ischemic dysfunction.
Impact:
- Findings highlight the differential impact of infarction location on biventricular function.
- The study suggests that RV dysfunction in IWI may involve partially reversible ischemic mechanisms beyond myocardial scarring.
- This research provides insights into the complex interplay between LV infarction and RV performance in coronary heart disease patients.
Abstract:
In 58 patients (pts) with coronary heart disease volume parameters of both ventricles were determined from two angiograms . Four groups of pts were formed according to localization of left ventricular damage: group I (24 PTS) without myocardial infarction, group II (17 pts) with anterior wall infarction (AWI), group III (9pts) with inferior wall infarction (IWI), and group IV (8 pts) with AW and IWI. In group I enddiastolic volume (EDV) of the left ventricle (LV) was 135 +/- 61 ml/1.73 m2, of the right ventricle (RV) 145 +/- 62 ml/1.73 m2, the ejection fraction (EF) 74% (LV) and 66% (RV). In group II EDV of LV increased significantly (194 +/- 88) and EF decreased to 50%, whereas EDV and EF of RV remaine unchanged. In group III EDV (LV 160 +/- 46, RV 172 +/- 95) of both ventricles was increased and EF (LV 57%, RV 58%) decreased, In group IV a more pronounced increase in EDV (LV 218 +1- 58, RV 181 +/- 30) and decrease in EF (LV 46%, RV 48%) was seen. A disturbance in contraction of RV was observed only in cases with IWI of LV. In contrast to LV, a diffuse impairment of RV occured. It was assumed that in RV disturbances in contraction exceeded the extent of scarred areas which might be explained by partially reversible ischemic disturbances of function.