Left ventricular (LV) systolic function is often measured with echocardiography using LV ejection fraction (LVEF) or global longitudinal peak systolic strain (GLPSS). Global wasted work (GWW), global work efficiency (GWE), and first-phase ejection function (LVEF-1) are newer LV systolic function indices. We examined these parameters in 45 healthy individuals and 50 patients with stable coronary artery disease (CAD), normal LV contractility, and LVEF > 50%. Compared to healthy individuals, CAD patients had similar LVEF but increased GLPSS and GWW and reduced GWE and LVEF-1. The highest area under the receiver operating characteristic for detecting CAD was found for LVEF-1 (0.84; 95% CI 0.75–0.91; p < 0.0001), and it was significantly larger than for GLPSS (+0.166, p = 0.0082) and LVEF (+0.283, p = 00001). For LVEF-1 < 30%, the odds ratio for the presence of CAD was 22.67 (95% CI 6.47–79.44, p < 0.0001) in the logistic regression adjusted for age, sex, and body mass index. Finding LVEF-1 < 30% in an individual with normal LV myocardial contraction and preserved LVEF strongly suggests the presence of CAD.

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Introduction. The Reflection Index (RIDVP) derived from digital volume pulse (DVP) analysis has proved to be useful in the assessment of endothelium-dependent vasodilation induced by albuterol. Little is known of the effect of shear-stress-induced vasorelaxation on RIDVP. Material and Methods. Thirty three healthy volunteers (22 females, 11 males, mean age 57 yrs) were recruited. Assessment of endothelium-dependent vasorelaxation was performed by the analysis of digital volume pulse after albuterol challenge or locally-induced hyperemia. Results. he hyperemia-induced vasodilation led to a signifi cant decrease of RI DVP in comparison with the values obtained at rest (∆RI Hyper 69 ± 2 % vs 64 ± 2, p < 0.0001). Similarly albuterol administration resulted in a signifi cant drop in RI DVP (∆RI Alb 71 ± 2 % vs 67 ± 2 %, p < 0.0001). There was no signifi cant difference between ∆RI Hyper and ∆RI Alb (5.2 ± 0.8 % vs 4.6 ± 1.0 %, p = 0.61). We observed a signifi cant correlation between the small vessel reaction in response to albuterol or hyperemia (r = 0.52, p = 0.01). Conclusions.Our study demonstrated that hyperemia-induced changes in the Reflexion Index derived from the digital volume pulse are similar to those observed after albuterol-challenge and both are correlated.