[Angiography of left ventricle following volume load and physical work in coronary disease]

In order to recognize and quantitate abnormalities in wall segment motion in 22 patients simultaneous measurements of isovolumic and ejection phase parameters were performed with the Millar-angiographic catheter at rest, after leg raising and during bicycle exercise. 6 patients had slight coronary heart disease (CHD) (group I), 16 patients had severe CHD (group II). During volume load in all patients of gr. II a decrease of peak measured velocity (Vpm) and the velocity of circumferential fiber shortening (Vcf from 1.4 to 1.1 circ/s, p less than 0.025) occurred. In gr. I Vcf increased (p less than 0.05). During exercise there was a high increase in Vpm and Vcf in gr. I (from 1.2 to 1.9 circ/s) whereas in gr. II no increase was observed. LVEDP rose to 29 mm Hg and ESV from 58 to 70 ml/1.73 m2. By increasing LVEDP during volume load underperfused areas became ischaemic and akinetic. During physical work the segmental abnormality can be less pronounced possibly due to the higher prestenotic pressure.