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The effect of left ventricular diastolic dysfunction on the pathogenesis of angina decubitus
Insights
Patients with angina decubitus (AD) exhibit left ventricular (LV) diastolic dysfunction. This dysfunction, characterized by impaired LV filling and elevated pressures, may play a key role in the development of AD.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Angina decubitus (AD) is a chest pain condition.
- The underlying mechanisms of AD are not fully understood.
- Left ventricular diastolic dysfunction (LVDD) affects heart relaxation and filling.
Purpose of the Study:
- To investigate the role of left ventricular diastolic dysfunction in the pathogenesis of angina decubitus.
Main Methods:
- Compared three groups: healthy individuals (I), coronary artery disease patients without AD (II), and AD patients with preserved ejection fraction (III).
- Matched groups II and III for age, ejection fraction, and coronary artery disease extent.
- Utilized left ventriculography (LVG) to assess left ventricular filling dynamics and pressures.
Main Results:
- Group III showed significantly lower early diastolic filling (1/3FF) and higher late diastolic filling (late 1/3 FF) compared to groups I and II.
- Left ventricular end-diastolic pressure (LVEDP) was elevated in groups II and III versus group I.
- The difference in LVEDP due to left atrial contraction (LACPD) was significantly higher in group III, with notable intra-group changes.
Conclusions:
- Patients with angina decubitus demonstrate significant left ventricular diastolic dysfunction.
- LV diastolic dysfunction is strongly implicated in the pathogenesis of angina decubitus.
Objective:
To investigate the effect of left ventricular diastolic dysfunction on the pathogenesis of angina decubitus (AD).
Methods:
The study population consisted of three groups: 20 individuals without cardiovascular studied as group I. Group II included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction (EF) > 50% were studied as group III. Group II and III were matched for age, EF and extent of coronary artery disease.
Results:
Left ventriculography (LVG) showed that left ventricular (LV) first 1/3 filling fraction (1/3FF) was significantly lower in group III than in group II and I (both P < 0.001), but LV late 1/3 FF was much higher in group III than in group II and I (P < 0.05, P < 0.01). Left ventricular end-diastolic pressure (LVEDP) was markedly increased before and after LVG in group II and III as compared with group I (both P < 0.05, both P < 0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD) before and after LVG was much higher in group III than in group I ( P < 0.01, P < 0.001). However, there we significant differences in LVEDP and in LACPD between before and after LVG only in group III (both P < 0.01).
Conclusion:
The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogenesis of angina decubitus.