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Related Experiment Videos

Left ventricular diastolic filling in patients with left ventricular dysfunction.

S J Lavine, V Krishnaswami, D P Shreiner

    International Journal of Cardiology
    |August 1, 1985
    PubMed
    Summary

    Abnormal left ventricular diastolic filling patterns are common in patients with severe heart dysfunction from coronary disease or cardiomyopathy. These patterns, characterized by increased peak filling rate to peak ejection rate ratios and stroke volume filling, may relate to elevated pulmonary capillary pressure.

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    Area of Science:

    • Cardiology
    • Cardiac Imaging
    • Heart Failure Research

    Background:

    • Left ventricular diastolic dysfunction is crucial in heart failure.
    • The specific patterns in coronary artery disease (CAD) with severe dysfunction are not well understood.
    • Gated blood pool scans offer insights into cardiac filling dynamics.

    Purpose of the Study:

    • To investigate the left ventricular diastolic filling patterns in patients with severe left ventricular dysfunction.
    • To compare these patterns between coronary artery disease and congestive cardiomyopathy.
    • To assess the specificity of these patterns and their relation to pulmonary capillary pressure.

    Main Methods:

    • Utilized gated blood pool scans to derive left ventricular diastolic filling curves.

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  • Analyzed parameters including peak filling rate (PFR), peak ejection rate (PER), PFR/PER ratio, % stroke volume at 1/3 diastole (%SV-1/3 DT), and % stroke volume at rapid filling (%SV-RFP).
  • Compared data from 21 normal subjects, 61 CAD patients (ejection fraction ≤30%), and 51 congestive cardiomyopathy patients (ejection fraction ≤30%).

    • Main Results:

    • Both CAD and congestive cardiomyopathy groups showed reduced PFR and PER.
    • The PFR/PER ratio was significantly increased in both patient groups compared to normals (CAD: 1.19±0.28, Cardiomyopathy: 1.21±0.32 vs. Normal: 0.93±0.20).
    • Both patient groups exhibited higher %SV-1/3 DT and %SV-RFP, with further increases noted in patients with elevated mean pulmonary capillary pressure (≥18 mm Hg).

    Conclusions:

    • An abnormal, non-specific left ventricular diastolic filling pattern exists in severe CAD and congestive cardiomyopathy.
    • This pattern is defined by an elevated PFR/PER, increased %SV-1/3 DT, and augmented %SV-RFP.
    • Elevated pulmonary capillary pressure may contribute to these observed diastolic filling abnormalities.