Left ventricular dysfunction in patients with angina pectoris and normal coronary angiograms

Area of Science:

• Cardiology
• Cardiovascular Physiology

Background:

• Angina pectoris often indicates coronary artery disease.
• However, some patients with angina have normal coronary angiograms, suggesting other underlying causes for their symptoms.

Purpose of the Study:

• To investigate left ventricular (LV) function in patients presenting with angina pectoris and normal coronary angiograms.
• To identify potential associations between LV dysfunction and clinical factors like smoking.

Main Methods:

• Left ventricular function was assessed using angiograms in 201 patients with angina and normal coronary arteries.
• Regional wall motion analysis was performed on 187 patients.
• Systolic and diastolic dysfunction were evaluated, along with left ventricular volumes, ejection fraction, and exercise capacity.

Main Results:

• Of the 187 analyzed, 66 patients exhibited hypokinetic segments, indicating regional wall motion abnormalities.
• Patients with hypokinesia had significantly higher end-systolic volume, lower ejection fraction, and reduced exercise capacity.
• Left ventricular diastolic dysfunction was present in 20% of patients, and 11% had both systolic and diastolic dysfunction.
• Smokers were significantly more prevalent in the group with hypokinetic segments.

Conclusions:

• A significant proportion of patients with angina and normal coronary angiograms exhibit left ventricular systolic and/or diastolic dysfunction.
• Smoking appears to be associated with left ventricular regional wall motion abnormalities in this patient cohort.