Left ventricular regional dysfunction induced by intracoronary papaverine in patients with isolated stenosis of the left anterior descending coronary artery.
Intracoronary papaverine was administered to eight subjects with normal coronary arteries and to nine patients with single-vessel disease of the left anterior descending coronary artery. All patients had normal left ventricular function at baseline. After papaverine, global and regional ventricular function were unchanged in the normal group. In patients with left anterior descending coronary artery stenosis, intracoronary papaverine resulted in significant wall motion abnormalities and decrease of ejection fraction (from 65 +/- 6% to 54 +/- 9%, p less than 0.01). A full spectrum of responses was observed, however, in these patients, some having almost no change of regional wall motion while others had large anterior dyskinesis. No relationship was found between the severity of the stenosis and the amount of regional dysfunction induced by intracoronary papaverine. These data demonstrate the lack of relationship between the angiographic severity of a stenosis and its impact on left ventricular segmental contraction. This suggests that techniques aimed at producing wall motion abnormalities by means of coronary anterior vasodilation may not be recommended as first-line strategy for the detection of patients with coronary artery disease.
Foult
J M
JM
Service d'Explorations Fonctionnelles, CHU Xavier-Bichat, Paris, France.
Nitenberg
A
A
Aptecar
E
E
Azancot
I
I
D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003331:Coronary Vessels; D006801:Humans; D007267:Injections; D010208:Papaverine / Q000494:pharmacology*; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000187:drug effects*
D010208:Papaverine