Abnormal left ventricular wall movement during early systole in patients with angina pectoris.

Gibson, D G; Doran, J.; Traill, Thomas A.; Brown, D J

doi:10.1136/hrt.40.7.758

Cited by 47 publications

(21 citation statements)

References 12 publications

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“…Our results strongly suggest that the primary factor in the development of asynchrony is local delay in the whole long axis contraction sequence, demonstrated by a consistent delay in its onset (the time interval q-OS), which correlated strongly with the increase in the duration of postejection shortening (A2-OL). It has previously been suggested that this delay in the onset of shortening might be electrical in origin [7], and our results would support this mechanism, with strong correlation between changes in QRS duration and q-OS, both pre-and post-operatively. If these ideas are correct, they would explain the close interrelations between activation changes, ventricular asynchrony, total isovolumic time, and the cardiac output response to pharmacological stress observed pre-and post-operatively.…”

Section: Mechanism Of Asynchronysupporting

confidence: 88%

Electromechanical left ventricular resynchronisation by coronary artery bypass surgery

Duncan

Francis

Gibson

et al. 2004

European Journal of Cardio-Thoracic Surgery

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Section: Mechanism Of Asynchronysupporting

confidence: 88%

Electromechanical left ventricular resynchronisation by coronary artery bypass surgery

Duncan

Francis

Gibson

et al. 2004

European Journal of Cardio-Thoracic Surgery

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“…For example, even normal ventricles exhibit asynchronous contraction which worsens during ischemia [11,12]. Reduction of the angiographic frame rate may jeopardize accuracy in measuring parameters of the timing of volume change and wall motion in systole and diastole, and therefore cannot be recommended for such studies on the basis of the present results.…”

Section: Discussionmentioning

confidence: 78%

Accuracy of quantitative ventriculographic analysis at reduced frame rates

Sheehan

1999

Cathet. Cardiovasc. Intervent.

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Objective: We measured the error in left ventricular (LV) volume and wall motion measurement from recording contrast ventriculograms at 15 frames/sec instead of 30 frames/sec. Background: Angiograms are increasingly recorded at 15 frames/sec instead of 30 frames/sec to improve efficiency. However the resulting error in quantitative analysis has not been evaluated. Methods: Contrast ventriculograms recorded at 30 frames/sec of 23 patients undergoing diagnostic studies were digitized from cine film. End diastolic volume (EDV), end systolic volume (ESV), ejection fraction, anterior wall motion, and inferior wall motion were measured from a full set recorded at 30 frames/sec and from two reduced data sets at 15 frames/sec generated from the even and odd numbered frames. Intraobserver variability was compared with the error due to frame rate reduction. Results: The error due to frame rate reduction did not differ significantly from intraobserver variability (p > 0.1 for all), measuring 2.6 ± 2.2 ml (r = 0.997) vs. 1.9 ± 1.2 ml (r = 0.999), respectively for EDV, 2.4 ± 1.8 ml (r = 0.991) vs. 2.1 ± 1.7 ml (r = 0.994), respectively for ESV, and 0.2 ± 0.2 percent (r = 0.981) vs. 0.1 ± 1.2 percent (r = 0.994), respectively for ejection fraction. The error and variability for wall motion were 0.3 ± 0.3 SD (r = 0.928) vs. 0.2 ± 0.1 SD (r = 0.946), respectively for the anterior wall and 0.2 ± 0.2 SD (r = 0.963) vs. 0.2 ± 0.1 SD (r = 0.968), respectively for the inferior wall. Conclusion: Imaging the LV at 15 frames/sec does not cause a significant error in measuring LV volume and function compared with imaging at 30 frames/sec. Cathet. Cardiovasc, Intervent. 48:18–21, 1999. © 1999 Wiley‐Liss, Inc.

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“…Normal outward movement is seen during filling. The overall amplitude of inward movement is 7 within the normal range for this region. Wall motion in the inferior part of the cavity is normal, both with respect to amplitude and to its time relations, and rapid outward motion of endocardium during ventricular filling is preserved.…”

Section: Overall Left Ventricular Functionmentioning

confidence: 79%

Asynchronous left ventricular wall motion early after coronary thrombosis

1986

Heart

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SUMMARY To study regional wall motion early in the development of acute myocardial infarction, left ventriculograms performed in 24 patients before thrombolysis and within 3-5 (1-2) (mean (SD)) hours of the onset of pain were digitised frame by frame. Isometric and contour plots of regional wall motion were constructed. In 19 patients (seven with anterior descending, eight with right, and four with circumflex disease) thrombosis was demonstrated on an underlying stenosis. In 10 patients the two remaining coronary arteries were normal, and in nine, one or both showed important disease. Mean values of global indices of left ventricular function, including end diastolic volume, ejection fraction, peak ejection and filling rates, and cavity shape changes were all within normal limits, though end systolic volume was significantly raised. Total systolic amplitude of wall motion was normal in the affected area in all but seven patients (four with anterior descending, two with right, and one with circumflex thrombosis). Dyskinesis of more than 2 mm was seen in only three patients, all with thrombosis of the anterior descending coronary artery, and hyperkinesis was present in four. The commonest abnormality of wall motion was hypokinesis during ejection followed by prolonged inward motion during isovolumic relaxation, which was seen in four patients with anterior descending, seven with right, and three with circumflex artery thrombosis. This was preceded by outward motion during isovolumic contraction and delayed inward motion during ejection in eight with right or circumflex thrombosis. Five of six patients without thrombosis had simple hypokinesis or dyskinesis without asynchrony. Disease of other coronary arteries did not affect the pattern of wall motion seen after right or circumflex coronary artery occlusion but it reduced the incidence of delayed inward motion along the free wall after thrombosis of anterior descending artery. Thus early after acute coronary thrombosis asynchronous wall motion is commoner than simple hypokinesis or dyskinesis. Its persistence suggests that in the setting of coronary artery thrombosis in man, residual contractile activity may persist for up to six hours after the onset of symptoms.Selection of patients who are suitable for throm-of wall motion, the present study was designed to bolysis and acute revascularisation (for possible examine left ventricular contrast angiograms of limitation of infarct size) is difficult.1 2 The aim is to patients early after acute myocardial infarction with identify those in whom there is important particular reference to detecting asynchronous impairment of regional left ventricular function at a regional wall movement. We hoped that this would time when it is potentially reversible by re-provide a baseline for assessing the effects of establishment of coronary flow. Since myocardial procedures designed to limit infarct size and also that function manifests itself in the amplitude and timing it would be possible to recognise pattems of motion which woul...

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Abnormal left ventricular wall movement during early systole in patients with angina pectoris.

Cited by 47 publications

References 12 publications

Electromechanical left ventricular resynchronisation by coronary artery bypass surgery

Electromechanical left ventricular resynchronisation by coronary artery bypass surgery

Accuracy of quantitative ventriculographic analysis at reduced frame rates

Asynchronous left ventricular wall motion early after coronary thrombosis

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