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Left ventricular function during transient coronary occlusion: digital subtraction left ventriculograms during
1Department of Medicine, Bokuto Hospital, Tokyo, Japan.
Insights
Transient myocardial ischemia temporarily reduces left ventricular ejection fraction (EF). Pre-existing heart dysfunction exacerbates this effect, highlighting resting EF
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Diagnostic Imaging
Background:
- Transient myocardial ischemia can impair left ventricular (LV) function.
- Assessing LV function during ischemia is crucial for understanding cardiac response.
Purpose of the Study:
- To evaluate the impact of transient myocardial ischemia on left ventricular function.
- To investigate the relationship between pre-existing LV dysfunction and ischemic response.
Main Methods:
- Digital subtraction left ventricular angiography was used.
- Contrast medium was injected before, during (60s), and after balloon occlusion of coronary arteries (LAD or RCA).
- Ejection fraction (EF) was measured at these time points in 69 patients.
Main Results:
- Ejection fraction (EF) decreased during balloon inflation and recovered post-deflation.
- A trend towards lower EF and larger akinetic areas was observed with Left Anterior Descending (LAD) artery involvement.
- A linear correlation was found between resting EF and EF during ischemia.
Conclusions:
- Momentary coronary occlusion's effect on LV function is additive to pre-existing dysfunction.
- Resting ejection fraction is a key parameter for estimating LV function impairment during myocardial ischemia.
Abstract:
The impact of transient myocardial ischemia on left ventricular function was examined by digital subtraction left ventricular angiography. Contrast medium was injected into the right pulmonary artery before, at 60 seconds of balloon inflation, and 10 minutes after balloon deflation. A total of 69 patients completed the study. In 52 patients, the left anterior descending artery (LAD) was involved, and in 17, the right coronary artery (RCA) was the focus. Ejection fraction (EF) declined by balloon inflation and returned to baseline value after deflation of the balloon. There was tendency toward a lower EF and wider akinetic area for LAD dilatation. The linear correlation between resting EF and EF during balloon inflation suggested that the effect of momentary coronary occlusion on left ventricular function appears to be additive to pre-existing left ventricular dysfunction, and resting ejection fraction is an important parameter for estimating the degree of diminished left ventricular function during myocardial ischemia.