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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
11:04

Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

Published on: September 1, 2014

Effect of angina on the left ventricular diastolic pressure-volume relationship

T Mann, B R Brodie, W Grossman

    Circulation
    |May 1, 1977
    PubMed

    Insights

    Myocardial ischemia significantly increases left ventricular end-diastolic pressure. This rise in pressure during angina is due to impaired systolic function and altered diastolic properties, impacting cardiac performance.

    Area of Science:

    • Cardiology
    • Cardiovascular Physiology
    • Myocardial Ischemia Research

    Background:

    • Left ventricular end-diastolic pressure (LVEDP) is a key indicator of cardiac function.
    • Myocardial ischemia can affect both systolic and diastolic properties of the left ventricle.
    • Understanding these changes is crucial for managing ischemic heart disease.

    Purpose of the Study:

    • To investigate the impact of myocardial ischemia on left ventricular diastolic pressure and properties.
    • To evaluate changes in left ventricular diastolic pressure-volume curves during induced angina.
    • To determine the relationship between systolic performance and diastolic dysfunction in ischemia.

    Main Methods:

    • Cardiac catheterization was performed on 19 patients.
    • Left ventriculograms and micromanometer catheter data were collected before and after rapid atrial pacing.
    • Diastolic pressure-volume curves were constructed to assess left ventricular diastolic properties.

    Main Results:

    • Twelve patients with coronary artery disease developed angina and showed increased LVEDP (30 +/- 2 mm Hg) post-pacing compared to controls (18 +/- 2 mm Hg).
    • Ejection fraction decreased (0.57 +/- 0.03) and end-systolic volumes increased (74 +/- 9 cc) in patients with angina.
    • Post-pacing diastolic pressure-volume curves were shifted upward in angina patients, indicating higher diastolic pressure for any given volume.

    Conclusions:

    • Myocardial ischemia significantly elevates left ventricular end-diastolic pressure.
    • This elevation results from a combination of impaired left ventricular systolic performance and altered diastolic properties.
    • The findings highlight the complex mechanical changes occurring in the left ventricle during ischemic events.

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