Cineangiographic evaluation of diastolic properties of the left ventricle in man
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Left ventricular diastolic function was assessed in 110 patients with heart disease. Increased myocardial stiffness correlated with prolonged isovolumic relaxation time, and calcium antagonists improved relaxation in hypertrophic hearts.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Diastolic dysfunction is a key factor in various heart diseases.
- Understanding left ventricular diastolic properties is crucial for patient management.
Purpose of the Study:
- To evaluate left ventricular diastolic properties in patients with diverse cardiac conditions.
- To investigate the relationship between myocardial stiffness and diastolic filling parameters.
- To explore the effect of calcium antagonists on myocardial relaxation.
Main Methods:
- Cineangiography was used to assess diastolic properties in 110 patients.
- Parameters included maximal circumferential relaxation velocity (maxVcf), diastolic maximal dV/dt, volume change during early 1/3 of filling (V1/3), rapid filling time, and isovolumic relaxation time.
- Myocardial stiffness constant (K) was calculated at end-diastole.
Main Results:
- Increased myocardial stiffness constant (K) correlated with prolonged isovolumic relaxation time.
- Affected left ventricular segments with myocardial infarction or hypertrophy showed reduced and delayed relaxation.
- Calcium antagonists improved delayed relaxation in patients with left ventricular hypertrophy.
Conclusions:
- Myocardial stiffness is linked to isovolumic relaxation time, not necessarily early diastolic filling.
- Delayed myocardial relaxation in hypertrophied hearts may involve calcium-dependent mechanisms.
- Calcium antagonists show potential for treating diastolic dysfunction in specific cardiac conditions.
Abstract:
Diastolic properties of the left ventricle were evaluated cineangiographically in 110 patients with various heart diseases (19 normal cases, 13 mitral stenosis, 19 left ventricular volume overload, 18 coronary artery diseases without myocardial infarction, 27 myocardial infarction, 6 hypertrophic cardiomyopathy, 5 congestive cardiomyopathy and 3 chronic constrictive pericarditis). Early diastolic ventricular filling was assessed by diastolic maximal circumferential relaxation velocity (maxVcf), diastolic maximal dV/dt, volume change during early 1/3 of ventricular filling (V1/3), rapid filling time and isovolumic relaxation time; myocardial stiffness constant K was calculated at end-diastole. Increase in myocardial stiffness constant was not necessarily associated with abnormal indices measured during the early diastolic period but well correlate with isovolumic relaxation time. During the isovolumic relaxation period, the affected left ventricular segments where myocardial infarction or myocardial hypertrophy existed, showed reduced and delayed relaxation resulting in a total increase in the isovolumic relaxation period. Calcium antagonist was effective in improving the delayed relaxation in patients with left ventricular hypertrophy, suggesting a role of calcium on delayed myocardial relaxation in the hypertrophied heart.