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Regional left ventricular systolic function in patients with segmental early relaxation and normal coronary arteries
Insights
Patients with normal coronary arteries can have regional differences in left ventricular systolic function. Segmental early relaxation is linked to augmented systolic function in specific heart regions.
Area of Science:
- Cardiology
- Cardiac Physiology
- Echocardiography
Background:
- Left ventricular (LV) systolic function is crucial for cardiac output.
- Assessing regional LV function is important for diagnosing various heart conditions.
- Segmental early relaxation in patients with normal coronary arteries warrants further investigation.
Purpose of the Study:
- To investigate regional differences in left ventricular systolic function.
- To determine if these differences are associated with segmental early relaxation in patients with normal coronary arteries.
Main Methods:
- Angiographic assessment of segmental early relaxation in 16 patients with normal coronary arteries and chest pain.
- Regional function analysis using the area method on ventriculograms.
- Calculation of regional fractional area of shortening (FAS) for anterolateral and diaphragmatic regions.
Main Results:
- Patients with segmental early relaxation showed significantly greater anterolateral regional FAS (69 ± 4%) compared to those without (55 ± 11%).
- In patients with segmental early relaxation, anterolateral FAS was significantly higher than diaphragmatic FAS (69 ± 4% vs. 53 ± 9%).
- No significant regional difference in FAS was observed in patients without segmental early relaxation.
Conclusions:
- Regional differences in LV systolic function exist in patients with normal coronary arteries exhibiting segmental early relaxation.
- Augmented regional systolic function is present and localized to the areas of early relaxation.
- Segmental early relaxation is a potential indicator of regional systolic dysfunction in the absence of coronary artery disease.
Abstract:
The purpose of the study was to determine whether regional differences of left ventricular systolic function exist in patients with normal coronary arteries who manifest segmental early relaxation. The presence or absence of segmental early relaxation was determined angiographically in 16 patients with normal coronary arteries who underwent diagnostic cardiac catheterization because of chest pain. Seven patients had early relaxation localized to the left ventricular anterior wall and nine patients had no evidence of segmental early relaxation. Regional function was assessed from ventriculograms obtained in the right anterior oblique projection using the area method to calculate the regional fractional area of shortening. The fractional area of shortening of the anterolateral region was greater in patients with than in those without segmental early relaxation (69 +/- 4 versus 55 +/- 11%; p less than 0.01). In addition, in patients with segmental early relaxation, this variable exceeded the fractional area of shortening of the diaphragmatic region (69 +/- 4 versus 53 +/- 9%; p less than 0.01). There was no difference in the fractional area of shortening between these two regions in patients who did not manifest segmental early relaxation. These results suggest that regional differences in systolic function are present in patients with but not in those without segmental early relaxation. Augmented regional systolic function was observed in patients with segmental early relaxation and was limited to regions that manifested early relaxation.