Left ventricular performance as measured by ventriculography (end-diastolic volume, endsystolic volume, and left ventricular ejection fraction), end-diastolic pressure and systolic time intervals (PEPI, LVETI, PEP/LVET) were compared among patients with chronic stable angina pectoris and cine-angiographically demonstrable coronary artery disease. The patients were divided into two clinical groups, 66 in whom there was previously documented acute myocardial infarction and 48 patients in whom there was noclinical or electrocardiographic evidence of previous myocardial infarction. The data were compared to that in a third group of 41 patients with atypical chest pain who were found to have no coronary arterial disease and normal ventriculograms on cardiac catheterization. In the group of patients with previous myocardial infarction, there was signifiant deviation in all measures of left ventricular performance from the normal group and from the group of patients without previous myocardial infarction. The most significant changes were present in the left ventricular ejection fraction and PEP/LVET/. The group of patients without previous myocardial infarction demonstrated normal left ventricular ejection fraction and PEP/LVET. When the patients were grouped relative to the extent of coronary arterial occlusive disease, abnormal left ventricular performance was frequent among the patients with previous myocardial infarction (58% of all patients) in the presence of 1, 2, and 3 vessel diseases. In the absence of previous myocardial infarction, abnormal left ventricular performance was rare (2.4%). Previous myocardial infarction occurred in 97 and 95% of the patients found to have abnormal left ventricular performance by left ventricular ejection fraction and PEP/LVET, respectively. These studies document the critical role of previous myocardial infarction as the major determinant of gloval left ventricular dysfunction among patients with chronic stable angina pectoris due to coronary artery disease. The finding of an abnormal ejection fraction or an abnormal PEP/LVET in the patient with chronic stable angina provides significant evidence favoring the occurrence of previous myocardial infarction.
|Translated title of the contribution||A study of global left ventricular function in chronic stable angina: the role of myocardial infarction|
|Number of pages||10|
|Journal||Coeur et medecine interne|
|State||Published - Dec 1 1980|
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