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Related Experiment Videos

Asynchronous left ventricular wall motion in unstable angina

M Y Henein1, D J Patel, K M Fox

  • 1Cardiac Department, Royal Brompton Hospital, London, UK.

International Journal of Cardiology
|March 1, 1997
PubMed
Summary
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Unstable angina patients exhibit more severe left ventricular wall motion abnormalities than chronic stable angina patients, linked to coronary artery disease severity. These findings suggest a connection between wall motion issues and angina instability.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Left ventricular (LV) wall motion disturbances are key indicators in coronary artery disease (CAD).
  • Understanding the specific nature of these disturbances in unstable angina (UA) versus chronic stable angina (CSA) is crucial for diagnosis and management.
  • The interplay between symptom severity and CAD extent in causing these abnormalities requires further elucidation.

Purpose of the Study:

  • To characterize left ventricular wall motion disturbances in unstable angina patients.
  • To determine the influence of symptom severity and coronary artery disease extent on these abnormalities.
  • To compare findings in unstable angina with chronic stable angina and normal controls.

Main Methods:

  • Prospective study involving 30 unstable angina patients (triple CAD), 34 chronic stable angina patients (triple CAD or isolated LAD disease), and 21 normal controls.

Related Experiment Videos

  • Assessment of left ventricular cavity size and long axis shortening during isovolumic relaxation time (IVRT).
  • Evaluation of other long axis motion parameters and transmitral E/A ratio.

    • Main Results:

    • Patients with unstable angina showed significantly more marked and widespread (>3 mm) abnormal long axis shortening during IVRT (65% of LV sites) compared to chronic stable angina patients (minor <3 mm, 12% of LV sites).
    • Minor long axis abnormalities during IVRT were similar in CSA and UA and correlated with CAD severity.
    • Transmitral E/A ratio was reduced in both UA and CSA with triple vessel disease.

    Conclusions:

    • Abnormal left ventricular shortening during IVRT is more severe and generalized in unstable angina.
    • The incidence of minor long axis abnormalities is comparable in chronic stable and unstable angina and is related to coronary artery disease severity.
    • These wall motion abnormalities are closely associated with the development of instability in the context of coronary artery disease.