Left Ventricular Functional Capacity in Patients with Chronic Ischemic Heart Disease, with Special Reference to Severity and Extent of Coronary Artery Disease Kai Tsuiki 1 , Makio Hayasaka 1 , Masaki Oguma 1 , Ikuro Ohta 1 , Tetsuji Kaminishi 1 , Tohru Kanaya 1 , Shoji Yasui 1 1The First Department of Internal Medicine, Yamagata University School of Medicine pp.295-302
Published Date 1985/3/15
DOI https://doi.org/10.11477/mf.1404204617
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We studied the left ventricular ejection fraction (EF), the maximal phase delay (MPD) and thefirst-third filling fraction (IT) responses to supine exercise using first-pass radionuclide angiography in 71 patients with significant coronary artery disease, including 42 with previous transmural myocardial infarction (MI group) and 29 without MI (AP group). Severity and extent of coronary artery disease were assessed by Pujadas score (PS) system which we proposed previously and showed to be correlated well with indices for myocardial ischemia during stress.

The EF response to exercise (ΔEF) was roughly correlated with PS (r=0.31, n=52), although there was no difference in the correlation between MI (n=28) and AP (n=24) groups. The MPD response (ΔMPD) was fairly constant around O msec in cases with AP and with PS less than 9. Beyond that value of PS, there was a linear correla-tion (r=0.90, n=10) indicating that ventricular asynergy appeared and progressively increased as the coronary artery disease became more severe in AP group (n=23). With MI group (n=25), however, no such a correlation was found. The relationship between ΔEF and ΔFF was steeper in MI (ΔFF=1.33 (ΔEF)-12.9, n=15) as com-pared to AP (ΔFF =0.51 (ΔEF)-0.83, n=15).In these subgroups, there were no differences in the indices for adequacy of the stress.

These observations indicate that left ventricular wall motion abnormality (asynergy) induced on stress was evidenced on the phase response of radionuclide technique, but not on EF response in patients with AP. Scar tissue within the ventricular wall with MI may play an important role in determining ventricular mechanical property during stress.

Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.


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