Relation between left ventricular filling pressure and angiographic findings in coronary heart disease. Ventriculography used as a stress test.

Abstract

In 80 male patients with coronary heart disease maximum diastolic pressure in the left ventricle (LVMDP) (usually the top of the a wave), and 'post a' end-diastolic pressure (LVEDP) before and 2 and 3 minutes after ventriculography were correlated to angiographic estimates of left ventricular function (aneurysm, ejection fraction (EF), and to lesions shown by selective coronary arteriography using a score system (coronary artery lesions index, CALI).A significant correlation between CALI and LVEDP (or LVMDP) could not be shown either before or after ventriculography. Before ventriculography, however, LVEDP and LVMDP were good predictors of left ventricular dyskinesia (aneurysm and/or EF<50%). A positive and significant correlation between CALI and the LVEDP (and LVMDP) increments following ventriculography (A LVEDP, A LVMDP) wasfound in patients with LVEDP (or LVMDP) below 12 mmHg before ventriculography. Using ALVEDP the correlation coefficient was 0-51 (n=41, P<0.001, 95 per cent confidence interval 0-24 to 0-88). Using A LVMDP r=0-47 (n=41, 0 001 <P<0.01). A LVEDP>12 mmHg was found only in patients with triple vessel disease.

Microcirculatory Dysfunction in Cardiac Syndrome X: Role of Abnormal Blood Rheology

“…Their hypothesis is supported by intracoronary ultrasound and Doppler findings showing early signs of atherosclerosis in the majority of patients with ischemic chest pain and a negative angiogram [ 18 ]. Further, quantitative angiographic measures of blood‐flow velocity in coronary arteries of CSX patients suggest a slow flow phenomenon [ 9 ] that is known to be associated with impaired coronary‐flow reserve [ 19 ] and elevated left ventricular end diastolic pressure values [ 17 , 22 ].…”