Evaluation of left ventricular systolic and diastolic dysfunction during transient myocardial ischemia produced by angioplasty

Labovitz, Arthur J.; Lewen, Marc K.; Kern, Morton J.; Vandormael, Michel; Deligonal, Ubeydullah; Kennedy, Harold L.

doi:10.1016/s0735-1097(87)80266-8

Cited by 287 publications

(75 citation statements)

References 41 publications

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“…Although the predominant diastolic abnormality induced by transient ischemia is an impairment in relaxation, 20 the diastolic filling pattern may change during AMI, resulting in a restrictive filling pattern. 12,13 Several investigators have in fact observed an upward shift in the pressure-volume curve during AMI or ischemia as a result of an increase in resistance to LV filling or increased chamber stiffness.…”

Section: Diastolic Function and Amimentioning

confidence: 99%

Doppler-Derived Mitral Deceleration Time

et al. 1999

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Background-The relation between remodeling and left ventricular (LV) diastolic function has not yet been fullyinvestigated. The aim of this study was to determine whether early assessment of Doppler-derived mitral deceleration time (DT), a measure of LV compliance and filling, may predict progressive LV dilation after acute myocardial infarction (AMI). Methods and Results-Fifty-one patients (aged 61Ϯ11 years; 6 women) with anterior AMI successfully treated with direct coronary angioplasty underwent 2-dimensional and Doppler echocardiographic examinations within 24 hours of admission, at days 3, 7, and 30 and 6 months after the index infarction. Mitral flow velocities were obtained from the apical 4-chamber view with pulsed Doppler. End-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated with the Simpson's rule algorithm. Patients were divided according to the DT duration assessed at day 3 in 2 groups: group 1 (nϭ33) with DT Ͼ130 ms and group 2 (nϭ18) with DT Յ130 ms. Patency and restenosis rate at 6 months were similar between the 2 groups (94% group 1 vs 89% group 2; Pϭ0.52; 27% group 1 vs 33% group 2; Pϭ0.64, respectively). LV volume indexes were similar in both groups at baseline (EDVI: 71Ϯ3 group 1 vs 70Ϯ3 mL/m 2 group 2, Pϭ0.42; ESVI: 43Ϯ3 group 1 vs 48Ϯ3 mL/m 2 group 2, Pϭ0.13, respectively). From day 3 on, LV volume indexes progressively increased in group 2 and were significantly larger than those of group 1 at 6 months (LVEDVI 61Ϯ3 group 1 vs 104Ϯ6 mL/m 2 group 2, Pϭ0.00001; LVESVI 31Ϯ3 group 1 vs 73Ϯ6 mL/m 2 group 2, Pϭ0.00001, respectively). A significant inverse correlation was found between DT and changes in EDVI at 6 months (rϭϪ0.68; PϽ0.0000001). By stepwise multiple regression analysis among several clinical, demographic, angiographic, and echocardiographic variables, DT was the most powerful predictor of EDVI changes at 6 months (Pϭ0.02). Conclusions-These data suggest that early estimation (day 3) of Doppler-derived mitral DT provides a simple and accurate mean to predict late LV dilation after reperfused AMI. (Circulation. 1999;99:230-236.)

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Section: Diastolic Function and Amimentioning

confidence: 99%

Doppler-Derived Mitral Deceleration Time

et al. 1999

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“…Diastolic dysfunction without systolic dysfunction may appear at an early stage of myocardial ischemia in patients with coronary artery disease, compatible with the fact that left ventricular diastolic functions are more susceptible to ischemia than systolic functions 22 . Several studies have demonstrated that CSF is associated with myocardial ischemia, but data are limited on how the left ventricular functions are affected by this disease 2,3,5,23 .…”

Section: Discussionmentioning

confidence: 74%

Função endotelial vascular em pacientes com fluxo coronário lento e os efeitos do nebivolol

Güneş¹,

Gümrükçüoğlu

Akdağ

et al. 2011

Arq. Bras. Cardiol.

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“…6) Thus, myocardial ischemia induced by coronary spasm triggers diastolic dysfunction in advance of systolic dysfunction. Therefore, coronary spasm can be a cause of acute pulmonary edema via acute elevation of left ventricular filling pressure.…”

Section: Discussionmentioning

confidence: 99%

Acute Heart Failure Triggered by Coronary Spasm With Transient Left Ventricular Dysfunction

et al. 2017

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SummaryCoronary spasm is abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia. Coronary spasm induces not only depressed myocardial contractility, but also incomplete myocardial relaxation, which leads to elevated ventricular filling pressure. We herein report the case of a 55-year-old woman who had repeated acute heart failure caused by coronary spasm. Acetylcholine provocation test with simultaneous right heart catheterization was useful for the diagnosis of elevated ventricular filling pressure as well as coronary artery spasm. We should add coronary spasm to a differential diagnosis for repeated acute heart failure. (Int Heart J 2017; 58: 286-289) Key words: Coronary spastic angina, Acetylcholine provocation test, Right heart catheterization C oronary spasm is defined as abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia. 1,2) The prevalence of coronary spasm is greater in Japan than in Western countries, because of genetic and environmental factors.1,2) Coronary spasm induces not only depressed myocardial contractility, but also incomplete myocardial relaxation, which leads to elevated ventricular filling pressure.1) We herein report a case of repeated acute heart failure caused by coronary spasm, which was diagnosed by acetylcholine provocation test with simultaneous right heart catheterization. Case ReportA 55-year-old Japanese woman was admitted to our hospital with acute heart failure accompanied by CO 2 narcosis. Her blood pressure was 154/92 mmHg and her heart rate was 111 beats/min on admission. Her arterial blood gas analysis showed a pH of 6.83, pCO 2 of 117.0 mmHg, and pO 2 of 98.3 mmHg at a fraction of inspired oxygen of 70% with non-invasive positive pressure ventilation on admission. Chest X-rays showed pulmonary edema (Figure 1), an electrocardiogram (ECG) showed poor R progression in leads V1-V3 (Figure 2), and echocardiography showed diffuse severe hypokinesis with a global left ventricular ejection fraction (LVEF) of 35%. Serum creatine kinase (CK) and serum creatine kinase MB isoenzyme (CK-MB) levels were 347 IU/L and 38 IU/L, respectively. The brain natriuretic peptide level was 450 pg/mL. Although she had no risk factors for coronary artery disease except age and current smoking, she had a history of 2 emergent admissions in 4 months: the first one at another hospital and the second one at our hospital. In the first admission, she had acute respiratory failure accompanied by CO 2 narcosis, which needed mechanical ventilation. Neither echocardiography nor coronary angiography (CAG) was performed during the first admission. Although the cause of her acute respiratory failure was not elucidated, the tentative diagnosis at the hospital was acute exacerbation of bronchial asthma. In the second admission, she had acute decompensated heart failure and was admitted to our hospital. Although blood analysis showed an increased CK level (5234 IU/L), the CK-MB level (78 IU/L) did not reach 10% of the CK level. ECG showed negati...

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Evaluation of left ventricular systolic and diastolic dysfunction during transient myocardial ischemia produced by angioplasty

Cited by 287 publications

References 41 publications

Doppler-Derived Mitral Deceleration Time

Doppler-Derived Mitral Deceleration Time

Função endotelial vascular em pacientes com fluxo coronário lento e os efeitos do nebivolol

Acute Heart Failure Triggered by Coronary Spasm With Transient Left Ventricular Dysfunction

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