[Prolonged diastolic stunning after unstable anginal attacks].
To evaluate the changes in the left ventricular diastolic filling dynamics after severe myocardial ischemia, serial pulsed Doppler examinations of mitral flow were performed in 10 patients with unstable angina. Peak early and late filling velocities (E and A), the ratio (E/A), the area E (Ei) and A (Ai) and the ratio (Ei/Ai) were measured one, 3, and 7 days and one month after the last ischemic episode. Seven of 10 patients were treated with percutaneous transluminal coronary angioplasty (PTCA), and the same indexes were obtained one, 3, and 7 days and one month after PTCA. E/A and Ei/Ai increased significantly on the 3rd and 7th days, however, no further increase was observed one month after the last ischemic episode and after PTCA. Left ventricular diastolic dysfunction induced by severe myocardial ischemia persisted for several days after the stabilization of myocardial ischemia. After the ischemic episodes were stabilized by administering pharmacological therapy, left ventricular diastolic dynamics were unchanged before and after PTCA. These results indicate that there may be diastolic myocardial stunning in patients with unstable angina.
Kawase
Y
Y
Department of Medicine, National Cardiovascular Center, Suita.
Nonogi
H
H
Nakamura
N
N
Miyazaki
S
S
Fukami
K
K
Sumiyoshi
T
T
Haze
K
K
Hiramori
K
K
D000789:Angina, Unstable / Q000503:physiopathology* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology