Circulation, Vol 69, 933-942, Copyright © 1984 by American Heart Association
T Yamagishi, M Ozaki, T Kumada, T Ikezono, T Shimizu, Y Furutani, H Yamaoka, H Ogawa, M Matsuzaki and Y Matsuda
To study the relationship between global and regional filling of the left
ventricle, we conducted resting gated radionuclide ventriculographic
studies in 15 control subjects (group 1) and 22 patients with isolated
disease of the left anterior descending coronary artery (group 2). None had
had a previous myocardial infarction. A computer program subdivided the
image of the left ventricle into four regions. The time-activity and
first-derivative curves of the global and regional left ventricles were
computed. In the global left ventricle, the normalized peak filling rate
(PFR) was decreased (p less than .01) and the ratio of the time to PFR
(time interval from global end-systole to PFR) to the diastolic time,
TPFR/DT, was greater (p less than .02) in group 2 than in group 1. In the
regional left ventricle, in the side perfused by the stenosed vessel
(septal and apical), PFR was slightly decreased in the apical (p less than
.05), but not the septal region (p = NS); TPFR/DT was greater in the apical
(p less than .02) and in the septal region (p less than .01) in group 2. In
the normally perfused lateral side, there were no significant differences
in PFR or in TPFR/DT between group 1 and group 2. Total delta t/DT, which
was defined as the ratio of the sum of the absolute values of the time
differences from global PFR to regional PFR (septal, apical, and lateral)
to the diastolic time, was significantly greater in group 2 (0.09 +/- 0.05
vs 0.16 +/- 0.05; p less than .001). This indicates the existence of
asynchronous diastolic filling in the different regions of the left
ventricle in group 2. A negative correlation existed between total delta
t/DT and global PFR (r = -.64, p less than .001). Thus, in patients with
one-vessel disease, asynchronous diastolic filling occurs due to the
filling disturbance in the affected regions, which may cause impairment of
the filling of the global left ventricle.
ARTICLES
Asynchronous left ventricular diastolic filling in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography
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