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Effects of regional systolic asynchrony on left ventricular global diastolic function in patients with coronary

P Perrone-Filardi1, S L Bacharach, V Dilsizian

  • 1Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

Journal of the American College of Cardiology
|March 15, 1992
PubMed

Insights

Regional systolic asynchrony in patients with coronary artery disease impacts diastolic function. Abnormal wall motion, a sign of this asynchrony, correlates with prolonged filling times and higher pressures, indicating impaired diastolic filling.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Coronary artery disease (CAD) patients often exhibit diastolic dysfunction despite preserved global systolic function.
  • Regional systolic asynchrony is a potential contributor to diastolic impairment in CAD.

Purpose of the Study:

  • To assess the influence of regional systolic asynchrony on left ventricular diastolic function in patients with CAD and normal ejection fraction.
  • To differentiate the effects of normal versus abnormal regional wall motion on diastolic parameters.

Main Methods:

  • Radionuclide angiography was used to evaluate diastolic function in 60 CAD patients (30 with normal wall motion, 30 with abnormal wall motion) and 19 healthy volunteers.
  • Key parameters assessed included peak filling rate, time to peak filling rate, left ventricular end-diastolic pressure, and diastolic asynchrony via sector analysis.

Main Results:

  • Patients with CAD, regardless of wall motion status, showed significantly lower peak filling rates compared to normal subjects.
  • Abnormal wall motion (systolic asynchrony) was associated with a prolonged time to peak filling rate and elevated left ventricular end-diastolic pressure.
  • Diastolic asynchrony was significantly higher in both CAD patient groups compared to controls.

Conclusions:

  • Regional systolic asynchrony, indicated by abnormal wall motion, contributes to impaired left ventricular diastolic filling in CAD patients.
  • Diastolic dysfunction in CAD is multifactorial, with regional asynchrony playing a significant role alongside other factors.

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