Circulation, Vol 64, 315-323, Copyright © 1981 by American Heart Association
RO Bonow, SL Bacharach, MV Green, KM Kent, DR Rosing, LC Lipson, MB Leon and SE Epstein
To assess left ventricular (LV) diastolic filling at rest in patients with
coronary artery disease (CAD), we analyzed high-resolution time- activity
curves (10-20 msec/frame) obtained from gated radionuclide angiograms in
231 patients. Peak LV filling rate (PFR), expressed in end-diastolic
volumes per second (EDV/sec), was subnormal in CAD patients (1.8 +/- 0.6
[+/- SD] vs normal mean of 3.3 +/- 0.6, p les than 0.001) and time to PFR
(TPFR), measured from end-systole to PFR, was prolonged (171 +/- 41 msec vs
normal mean of 136 +/- 23 msec, p less than 0.001). These indexes were also
abnormal in the 141 patients with normal resting LV ejection fraction (PFR
= 2.1 +/- 0.5 EDV/sec; TPFR = 175 +/- 36 msec) and in 123 patients without
Q waves on the ECG (PFR = 2.1 +/- 0.5 EDV/sec; TPFR = 168 +/- 38 msec).
Abnormal LV filling at rest (PFR less than 2.5 EDV/sec or TPFR greater than
180 msec) was found in 91% of all patients with CAD, 86% of patients with
normal resting LV ejection fractions, 85% of patients without Q waves, and
82% of patients with normal resting LV ejection fraction, no resting
regional wall motion abnormalities and no Q waves. Thus, LV diastolic
filling, evaluated noninvasively by radionuclide angiography, is abnormal
in a high percentage of patients with CAD at rest independent of LV
systolic function or previous myocardial infarction.
ARTICLES
Impaired left ventricular diastolic filling in patients with coronary artery disease: assessment with radionuclide angiography
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