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Left ventricular function in coronary disease: serial studies in the absence of myocardial infarction or coronary
Insights
Left ventricular function varies in coronary artery disease patients without heart attack or surgery. Changes in ejection fraction and coronary artery disease progression showed no clear relationship, indicating unclear links to worsening angina.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) management often involves monitoring left ventricular (LV) function.
- Serial cardiac catheterization is used to assess disease progression and LV performance.
- Understanding LV function variability is crucial for patient management in CAD.
Purpose of the Study:
- To evaluate changes in left ventricular function and coronary artery disease (CAD) progression in patients with CAD.
- To investigate the relationship between LV function, CAD progression, and increasing angina.
- To assess LV function variability in the absence of myocardial infarction or coronary artery surgery.
Main Methods:
- Repeat cardiac catheterization was performed on 15 patients with CAD 7-45 months after an initial study.
- Left ventricular ejection fraction, volumes, and coronary artery disease status were assessed.
- Patients were monitored for myocardial infarction and coronary artery surgery between studies.
Main Results:
- Six patients showed significant deterioration in ejection fraction (p < 0.01).
- Eight patients demonstrated progression of coronary artery disease; 7 did not.
- Left ventricular asynergy was present in all 8 patients with CAD progression and 5 of 7 without, with no significant difference in LV function between these groups.
Conclusions:
- Left ventricular function demonstrates variable changes in patients with CAD, even without myocardial infarction or surgery.
- The relationship between LV function changes, CAD progression, and increasing angina remains unclear.
- Further research is needed to elucidate the factors influencing LV function variability in CAD.
Abstract:
Fifteen patients with coronary artery disease underwent repeat cardiac catheterization (R) 7-45 months (mean 19.4) after the initial study (I) because of increasing angina. No patient sustained a myocardial infarction between I and R or underwent coronary artery surgery. Left ventricular function exhibited variability between the two studies with 6 patients demonstrating deterioration in ejection fractions (I = 65.6 = +/- 14.0 vs R = 50.5 +/- 15.4 p less than 0.01); 5 patients had a slight increase and the remainder showed no change. Changes in left ventricular volumes were not significant. Eight patients demonstrated progression of their coronary artery disease. The remaining 7 patients did not demonstrate progression. All 8 patients with progression and 5 of 7 patients without coronary artery progression demonstrated left ventricular asynergy. There was no difference in left ventricular function in the group of patients with coronary progression vs. those without progression. We conclude that changes in LV function are variable in patients with coronary artery disease in the absence of myocardial infarction or coronary surgery, and the relationship to progression of coronary artery disease or increasing angina is unclear.