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[Left-ventricular function in patients with unstable stenocardia after pharmacological and surgical treatment]
Abstract:
Left-ventricular function was assessed by sectional echocardiography in 250 patients with unstable angina on admission; the test was repeated after medication-produced-stabilization in 130 and after aorto-coronary shunting in 50 of those. Total and/or regional left-ventricular contractility disorders were detected in 82.4%, depending on the type and severity of coronary bed affection as well as the presence and magnitude of postinfarction cardiosclerosis. The nitroglycerin test improved left-ventricular function in 83% of cases where it was initially depressed. Left-ventricular function was improved after medication in 79% of patients and after surgery in 60%. Total left-ventricular ejection fraction increased by an average of 11.2 +/- 1.5%, whereas the ejection fraction of segments, connected with the shunted-artery blood supply network, increased by 19.5 +/- 2.3% (p less than 0.01). The efficiency of pharmacological treatment depended on the number of affected coronary arteries and the presence and severity of postinfarction cardiosclerosis, while surgical treatment also depended on the extent of myocardial revascularization for its efficiency.