Effects of atrial pacing on global and regional left ventricular function in coronary heart disease assessed by digital intravenous ventriculography.
Digital i.v. ventriculography in conjunction with rapid atrial pacing was used to assess the effects of ischemic stress on global and regional function in 22 patients referred for cardiac catheterization (5 had normal coronary arteries and 17 had greater than 70% diameter reduction of at least 1 major coronary artery). End-diastolic, end-systolic and stroke volume indexes and the ejection fraction were determined by an area-length technique from the mask mode images before and after pacing. In addition, segmental responses were quantitated using a radial shortening method. Subjects with normal coronary arteries showed no overall change in the postpacing volume or ejection fraction indexes. Coronary patients showed no overall change in postpacing end-diastolic volume (86 +/- 25 ml/m2 at control vs 90 +/- 31 ml/m2 after pacing, difference not significant), but there was a significant increase in end-systolic volume (25 +/- 15 ml/m2 at control vs 32 +/- 18 ml/m2 after pacing, p less than 0.005) and a decrease in ejection fraction (72 +/- 11% at rest vs 64 +/- 18% after pacing, p less than 0.025). Furthermore, quantitative deterioration in wall motion was seen in 14 of 17 coronary patients (82%) and in none of the normal patients. Analysis of segmental wall motion was the most sensitive diagnostic variable. A combination of atrial pacing stress testing and digital i.v. ventriculography is useful in detecting functionally significant coronary disease through quantitation of global and regional dysfunction which does not require arterial cannulation.
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003974:Diatrizoate Meglumine; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011859:Radiography; D013318:Stroke Volume
D003974:Diatrizoate Meglumine