title: Impairment of left ventricular function during coronary angioplastic occlusion evaluated with a nonimaging scintillation probe.
abstract: Impairment of left ventricular function during controlled myocardial ischemia induced by coronary angioplasty has been reported from angiographic and echocardiographic studies. Ejection fraction, peak ejection, peak filling rates, and end-systolic and end-diastolic volumes were investigated before, during and after coronary occlusion on-line with a nonimaging scintillation probe. The study consisted of 18 patients (mean age 59 +/- 10 years) with coronary artery stenosis of greater than 70%. During balloon inflation of 60 seconds' duration, coronary occlusion pressure was 31.6 +/- 12 mm Hg. There was no significant change in heart rate. Delay between first and second dilatation was 109 +/- 63 seconds. Ejection fraction decreased from 53 +/- 16 to 40 +/- 12% (first dilatation, p less than 0.01) and to 39 +/- 14% (second dilatation, p less than 0.01) and recovered to 51 +/- 16% 5 minutes after the second dilatation. Peak ejection rate was significantly reduced during the first and second balloon inflations. Peak filling rate decreased from 2.5 +/- 0.8 to 2.0 +/- 0.7 end-diastolic volume.s-1 (first dilatation, p less than 0.01) and to 1.8 +/- 0.7 end-diastolic volume.s-1 (second dilatation, p less than 0.01) and remained reduced at 2.2 +/- 0.7 end-diastolic volume.s-1 (p = not significant) at 5 minutes after the second dilatation. End-systolic and end-diastolic volumes increased significantly during the first and second dilatations and returned to normal after dilatation. It is concluded that short, controlled myocardial ischemia during coronary angioplasty leads to a decrease in systolic and diastolic left ventricular function. Sequential dilatations do not further decrease function if a sufficient interval is kept.
authors.affiliation: Department of Cardiology, J.W., Goethe-University Medical Center, Frankfurt, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.forename: F D
authors.initials: FD
authors.lastname: Maul
authors.forename: M
authors.initials: M
authors.lastname: Zimny
authors.forename: H
authors.initials: H
authors.lastname: Klepzig
authors.forename: C
authors.initials: C
authors.lastname: Vallbracht
authors.forename: H G
authors.initials: HG
authors.lastname: Kneissl
authors.forename: R
authors.initials: R
authors.lastname: Schräder
authors.forename: G
authors.initials: G
authors.lastname: Hör
authors.forename: M
authors.initials: M
authors.lastname: Kaltenbach
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D002302:Cardiac Output / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology; D002586:Cesium; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D004562:Electrocardiography; D015637:Gated Blood-Pool Imaging / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007454:Iodides; D008297:Male; D008875:Middle Aged; D013670:Sodium Pertechnetate Tc 99m; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D007454:Iodides; D002586:Cesium; D013670:Sodium Pertechnetate Tc 99m; C040050:cesium iodide