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Left ventricular diastolic filling in patients with coronary artery disease without myocardial infarction
T Inoue1, S Morooka, T Hayashi
1Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Insights
Coronary artery disease impairs left ventricular diastolic function, affecting filling rates and timing. This study reveals diastolic dysfunction in patients with coronary artery disease, even without prior heart attacks.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Coronary artery disease (CAD) can affect cardiac function beyond systolic performance.
- Left ventricular diastolic dysfunction (LVDD) is an important clinical manifestation of cardiac disease.
Purpose of the Study:
- To investigate resting left ventricular diastolic function in patients with CAD but no history of myocardial infarction.
- To compare diastolic filling parameters between CAD patient subgroups and healthy controls.
Main Methods:
- Cine left ventriculography was used to analyze serial left ventricular volume and radial axes.
- Diastolic filling was assessed in 24 patients with CAD and 7 healthy controls.
Main Results:
- Patients with left anterior descending artery (LAD) disease and multivessel disease (MVD) showed significantly decreased peak filling rates.
- Time to peak filling rate was prolonged in LAD, right coronary artery (RCA), and MVD groups.
- Disturbed rapid and slow filling patterns were observed in MVD, while LAD and RCA groups showed impaired rapid filling.
Conclusions:
- Coronary artery disease, even without myocardial infarction, is associated with significant left ventricular diastolic dysfunction.
- Specific coronary artery lesions (LAD, MVD) have distinct impacts on diastolic filling dynamics.
- Diastolic dysfunction parameters like filling fraction and radial distension are reduced in CAD patients, varying by affected coronary territories.
Abstract:
Left ventricular diastolic dysfunction at rest was studied in 24 patients with coronary artery disease but no evidence of previous myocardial infarction. Seven patients with normal coronary arteries were studied as control. Diastolic filling was analyzed by the serial left ventricular volume and 14 radial axes from the gravity point of the left ventricle with cine left ventriculography. There were no differences in the systolic function between coronary artery disease and the normal control. Peak filling rate was decreased significantly in the groups with left anterior descending artery disease (LAD, p less than 0.05) and multivessel disease (MVD, p less than 0.05), but not in the group with right coronary artery disease (RCA). Time to peak filling rate was prolonged in each group of LAD (p less than 0.05), RCA (p less than 0.05), and MVD (p less than 0.001), compared with controls. The time-volume curve showed disturbed rapid filling in the LAD and RCA groups, and also both depressed rapid and slow filling in the MVD group. In the LAD group, the filling fraction was decreased significantly at the time of 25% of the diastolic period (p less than 0.001) and radial distension to the anterior wall was decreased at the time of 25%, 50%, and 75% of the diastolic period, compared with controls. In the RCA group, the filling fraction (p less than 0.001) and radial distension to the posterior wall were decreased only at the time of 25% of the diastolic period. In the MVD group, filling fraction and radial distension to the most wall were decreased at 25%, 50%, and 75% of the diastolic period.(ABSTRACT TRUNCATED AT 250 WORDS)