Left ventricular function and extent of coronary artery disease in the absence of antecedent myocardial infarction in patients with ischemic cardiac pain.
Left ventricular (LV) function and extent of coronary artery disease (CAD) are important prognostic factors in patients with ischemic cardiac pain (ICP). This study was designed to compare LV function in patients with ICP admitted to our coronary care unit (CCU). Patients with previous transmural myocardial infarction (TMI) or who were over age 75 were excluded. Group 1 (n = 17) developed their 1st TMI; group 2 (n = 14) were diagnosed as unstable angina (UA). All patients demonstrated significant CAD on arteriography; i.e., at least 70% stenosis of at least 1 major coronary vessel. LV function was evaluated by single plane ejection fraction (EF), end-diastolic volume index (EDVI) (ml/m2), and the slope of a modified LV function curve (S) utilizing change in CI divided by change in end-diastolic pressure at rest and post-LV angio (ml X min X M-2 X mm Hg) (normal +/- SD: 176 +/- 39). Both TMI and UA patients had LV dysfunction; although group 1 had more severe abnormalities, they were not statistically significant. Eleven (65%) in group 1 and 10 (71%) of 14 in group 2 had multivessel CAD. We conclude that in patients without previous TMI admitted with ICP: (1) Those who do not develop TMI have similar LV dysfunction compared to those with TMI; and (2) TMI and UA patients have similar multivessel CAD.
D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000175:diagnosis; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology*