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[Left ventricular systolic and diastolic asynchronism in patients with ischemic cardiopathy: its effects on
1Cattedra di Medicina Nucleare, II Facoltà di Medicina, Università Federico II, Napoli.
Insights
Left ventricular asynchrony impacts diastolic function in coronary artery disease (CAD). This study found increased asynchrony in CAD patients, affecting their heart
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Coronary artery disease (CAD) can affect cardiac function.
- Left ventricular (LV) diastolic properties are crucial for heart health.
- The role of LV asynchrony in CAD's diastolic dysfunction is not fully understood.
Purpose of the Study:
- To investigate the influence of left ventricular asynchrony on diastolic filling in patients with coronary artery disease.
- To compare LV asynchrony and diastolic function between CAD patients and healthy individuals.
Main Methods:
- Rest radionuclide angiography was used to study 27 CAD patients and 39 normal subjects.
- Evaluated parameters included ejection fraction, peak filling rate, isovolumic relaxation period, and LV asynchrony indices.
- Two indices of LV asynchrony were assessed: regional time to end-systole variation and regional time to peak filling rate variation.
Main Results:
- CAD patients exhibited lower ejection fraction and peak filling rates compared to controls.
- A prolonged isovolumic relaxation period was observed in the CAD group.
- The coefficient of variation of regional time to peak filling rate was significantly higher in CAD patients, indicating greater asynchrony.
Conclusions:
- Left ventricular systolic and diastolic asynchrony is more pronounced in patients with coronary artery disease.
- LV asynchrony is inversely related to global peak filling rate in CAD patients.
- These findings suggest that LV asynchrony contributes significantly to the impaired diastolic properties observed in coronary artery disease.
Abstract:
To assess whether left ventricular asynchrony would influence filling in coronary artery disease, 27 patients with coronary artery disease and 39 normal subjects were studied by rest radionuclide angiography. Lower ejection fraction and peak filling rate were found in the coronary artery disease group (56% +/- 17% versus 65% +/- 6%, p less than 0.05; 1.8 +/- 0.7 versus 2.9 +/- 1.4 end-diastolic volumes/s, p less than 0.05). Moreover, the patients with coronary artery disease had a prolonged isovolumic relaxation period (114 +/- 86 ms versus 70 +/- 43 ms, p less than 0.05). Two indices of left ventricular asynchrony were evaluated: the coefficient of variation of regional time to end-systole, and the coefficient of variation of regional time to peak filling rate. The coefficient of variation of regional time to peak filling rate was higher in the coronary artery disease group (10.1% +/- 10%) than in the normal subjects (6.2% +/- 3.7%, p less than 0.05). Both these parameters were inversely related to global peak filling rate in the coronary artery disease group. These findings suggest that in patients with coronary artery disease left ventricular systolic and diastolic asynchrony plays a role in determining left ventricular diastolic properties.