[Diastolic flow analysis of the left ventricle after myocardial infarct].
The diastolic function of the left ventricle was investigated in 12 normal young volunteers, 10 older volunteers, 10 patients without evidence of coronary artery disease, 26 patients with inferior wall and 19 patients with anterior wall infarction at eight locations of the total circumference of the left ventricle using pulsed wave Doppler. The ratio of early diastolic inflow (Vmax E) to the maximal velocity of atrial contraction (Vmax A) was determined. Furthermore, the delay between the end of electrical diastole until the end of the A-wave of the pulsed Doppler was measured. The results were compared with a clinically used marker of myocardial ischemia, treadmill exercise testing. The E/A ratio was 2.03 +/- 0.51 in normal volunteers, 1.16 +/- 0.41 in older volunteers, 1.41 +/- 0.59 in patients without evidence for coronary artery disease, 1.28 +/- 1.13 in patients with inferior and 1.08 +/- 0.41 in patients with anterior wall infarction (p = 0.020 ANOVA). The diastolic delay at the apex was 47.3 +/- 8.9 ms in normal volunteers, 78.3 +/- 8.3 ms in older volunteers, 79.1 +/- 13.7 ms in patients without coronary artery disease, 109.1 +/- 12 ms in patients with inferior and 169.5 +/- 18.8 ms in patients with anterior wall infarction (p = 0.000 ANOVA). There was a correlation between the latter parameter of delay and the amount of pathological wall segments at wall motion analysis (r = 0.61, p = 0.007). In two patients with anterior myocardial infarction (11%) with significant diastolic delay intraventricular thrombi developed consecutively.(ABSTRACT TRUNCATED AT 250 WORDS)
Genth
S
S
II. Med. Klinik und Poliklinik, Johannes-Gutenberg-Universität, Mainz.
Zotz
R
R
Nixdorff
U
U
Erbel
R
R
Meyer
J
J
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000502:physiology*; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*
Diastolische Flussanalyse des linken Ventrikels nach Myokardinfarkt.