[Transmitral flow patterns during acute coronary artery occlusion: experimental and clinical evaluations by pulsed...

To evaluate left ventricular diastolic properties during acute myocardial ischemia, transmitral flow patterns were analyzed by two-dimensional pulsed Doppler echocardiography. In a preliminary study of transient coronary artery occlusion in anesthetized open-chest dogs, the following results were obtained: decreased peak velocity of rapid filling, prolonged rapid filling period, and compensatory increase in the peak velocity of atrial filling. These changes occurred nearly concomitantly with decreased cardiac output, elevated left atrial and left ventricular end-diastolic pressures, and decreased left ventricular systolic pressures. With reperfusion of the coronary artery, these parameters rapidly returned to the base line values. In acute and transient myocardial ischemia induced by intracoronary balloon inflation during therapeutic percutaneous transluminal coronary angioplasty (PTCA) in man, similar changes in these parameters were observed, and the changes were more marked in PTCA for the left anterior descending artery as compared with that of the right coronary artery. In conclusion, noninvasive two-dimensional pulsed Doppler echocardiography is of practical use in evaluating deterioration of the diastolic function of the left ventricle during acute and transient myocardial ischemia.