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[Modifications in the contraction and relaxation of the left ventricle in chronic ischemic cardiopathies. Study using
P Bareiss1, A Constantinesco, A Facello
1Service de cardiologie, CHRU de Strasbourg, Hôpital de Hautepierre.
Insights
Left ventricular filling abnormalities contribute to cardiac failure in chronic ischemic heart disease. Radionuclide angiography revealed reduced ejection fraction in patients with heart failure compared to controls.
Area of Science:
- Cardiology
- Medical Imaging
- Heart Failure Research
Background:
- Cardiac failure in chronic ischemic heart disease is often linked to impaired left ventricular function.
- Understanding the interplay between contraction and filling abnormalities is crucial for managing heart failure.
Purpose of the Study:
- To investigate the role of left ventricular filling abnormalities in the development of cardiac failure.
- To confirm the association between impaired filling and contraction abnormalities in ischemic heart disease.
Main Methods:
- Equilibrium radionuclide angiography was used to assess left ventricular contraction and relaxation.
- Analysis included ejection fraction, peak ejection rate, and peak filling rate calculations.
- Novel functional images and time histograms were employed for detailed spatial and temporal analysis.
Main Results:
- Patients with chronic ischemic heart disease and cardiac failure (G3) showed a significantly reduced ejection fraction (36.3%) compared to controls (G1, 60.3%).
- A group with ischemic heart disease without failure (G2) also had reduced ejection fraction (49.8%) compared to controls.
- Significant differences in ejection fraction were observed between all groups (G1-G2, G2-G3, G1-G3, all p<0.05).
Conclusions:
- Abnormalities in left ventricular filling are significant contributors to cardiac failure in chronic ischemic heart disease.
- Radionuclide angiography provides valuable insights into the functional deficits underlying heart failure.
- Further research into diastolic dysfunction mechanisms is warranted for improved therapeutic strategies.
Abstract:
Our purpose was to confirm that abnormalities of left ventricular filling, which are associated with abnormalities of contraction, play an important part in the genesis of cardiac failure in chronic ischaemic heart disease. We used equilibrium radionuclide angiography of the cardiac cavities to study the behaviour of the left ventricle during contraction and relaxation in three groups of patients: a control group of 15 patients without cardiac disease (G2), and a group of 28 patients with chronic ischaemic heart disease complicated by cardiac failure (G3). From the overall activity-time curves and their first derivatives were calculated the ejection fraction, the peak ejection rate and the peak filling rate, as well as the time in the cardiac cycle when these appeared, the reference point in time being the end-diastole. Separately, an analysis of spatial distribution, pixel by pixel, of the elementary values of these times was developed with the help of new functional images constructed, pixel by pixel, from the first derivatives of the activity-time curves. These functional images were exploited by calculating histograms of times, and the width of the bars at mid-height was taken as the dispersion parameter expressed as a percentage of the cardiac cycle. There was a significant reduction of ejection fraction in groups G2 (49.8 +/- 11.6 p. 100) and G3 (36.3 +/- 15.4 p. 100) as compared to control group G1 (60.3 +/- 8.4 p. 100) (G1-G2 p less than 0.05; G2-G3 p less than 0.001; G1-G3 p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)