Changes in left ventricular diastolic function in coronary artery disease with and without angina pectoris assessed from exercise ventriculography
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Coronary artery disease patients experienced increased left ventricular (LV) diastolic pressure and volume during exercise. Those with akinetic segments showed a greater increase, indicating depressed LV resting function.
Area of Science:
- Cardiology
- Physiology
Background:
- Coronary artery disease (CAD) affects left ventricular (LV) function.
- Understanding LV diastolic pressure-volume (P-V) relationships during exercise is crucial for assessing cardiac health.
Purpose of the Study:
- To evaluate LV diastolic P-V curves in normal individuals and CAD patients during exercise.
- To compare responses between CAD patients with and without angina, and with or without akinetic segments.
Main Methods:
- Obtained biplane ventriculograms and high-fidelity pressure measurements in 11 normals and 43 CAD patients.
- Assessed LV diastolic P-V curves at rest and during exercise.
- Categorized patients based on angina during exercise and presence of akinetic segments.
Main Results:
- During exercise, LV minimal and end-diastolic pressures and volumes increased similarly in CAD patients with and without angina.
- CAD patients with akinetic segments (group D) exhibited a larger mean increase in diastolic pressure and volume compared to those without (group C) at comparable workloads.
- The greater increase in group D correlated with depressed LV resting function.
Conclusions:
- LV diastolic P-V dynamics during exercise are altered in CAD patients.
- The presence of akinetic segments significantly impacts LV diastolic response to exercise, reflecting impaired resting function.
Abstract:
In 11 normals and 43 patients with coronary artery disease left ventricular (LV) diastolic pressure-volume (P-V) curves were obtained from biplane ventriculograms and simultaneous high fidelity pressure measurements. During exercise ventriculography 20 patients had angina pectoris (group B), and 16 patients were asymptomatic (group A). At rest there were no akinetic segments in 28 patients (group C), and an akinetic segment was found in 15 (group D). With different total work loads (951 +/- 134 and 2100 +/- 245 kpm in groups B and A), LV minimal and end-diastolic pressures and corresponding ventricular volumes increased to a similar extent in patients with and without angina during exercise ventriculography. With comparable work loads (1,296 +/- 221 and 1,494 +/- 195 kpm in groups C and D) the mean increase in diastolic pressure and volume was larger in group D, which corresponded to the more depressed LV resting function.