[Angiographic course of advanced ischemic cardiopathy]

We studied 30 patients with significant coronary artery disease awaiting coronary surgery for 7 to 64 months (mean 16 months), who underwent repeated cineangiogram. On the basis of clinical and angiographic factors the following conclusions were obtained: Age, intervals between angiograms, risk factors, progression in angina, functional class and electrocardiographic changes were associated with progression of angiographic coronary artery obstructions (p greater than 0.05). Lower progression percentages were observed in patients with one-vessel disease compared with those with two or three-vessel involvement (p greater than 0.05). No difference could be found in the progression of obstruction of any of the main coronary vessels. Collateral circulation increased with the anatomic obstruction progression. The changing coronary pathology was significantly related to increasing impairment of left ventricular function manifested as increased segmental motility impairment and decrease in ejection fraction (p less than 0.05). Deterioration of left ventricular contraction measured by means of non-invasive diagnostic tests could predict the need of a second arteriography.