1 From the Department of Medicine, Queen's University, and Kingston General Hospital, Kingston, Ontario, Canada, and Department of Medicine, St. Luke's Hospital, New York, New York.
Myocardial lactate metabolism was monitored before, during, and after a period of atrial pacing with a continuous automated sampling technic. The electrocardiogram was recorded, and left ventricular function was evaluated by relating left ventricular end-diastolic pressure to left ventricular stroke work. Seventeen of 21 patients with coronary artery disease experienced angina during pacing, and 13 of these showed lactate production by the myocardium during angina. The abnormalities in lactate metabolism developed early in the pacing period, along with S-T segment depression and impairment of left ventricular function, all of which usually occurred before the onset of pain. In the patients with angina, the mean lactate extraction was 14.1% during the control period and —15.1% during the pacing period. Abnormalities in myocardial lactate metabolism have been demonstrated with greater regularity during pacing-induced angina than during angina precipitated by exercise or isoproterenol. This investigation has demonstrated the sequences of changes in lactate metabolism during and after a period of angina and their relation to electrocardiographic and hemodynamic events.
© 1969 American Heart Association, Inc.
Sequential Alterations in Myocardial Lactate Metabolism, S-T Segments, and Left Ventricular Function During Angina Induced by Atrial Pacing
Key Words: Myocardial metabolism • Oxygen consumption • Coronary artery disease • Oxygen saturation • Oxygen and carbon dioxide tensions • ECG hemodynamics
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