Asynchronous left ventricular wall motion in unstable angina

被引:15
作者
Henein, MY [1 ]
Patel, DJ [1 ]
Fox, KM [1 ]
Gibson, DG [1 ]
机构
[1] ROYAL BROMPTON HOSP,DEPT CARDIAC,LONDON SW3 6NP,ENGLAND
关键词
unstable angina; long axis function; diastole; asynchrony;
D O I
10.1016/S0167-5273(96)02908-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The objective of the study was to assess the nature of left ventricular wall motion disturbances in patients with unstable angina and the relative contributions of the severity of symptoms and the severity of coronary artery disease (CAD) to their genesis. A prospective examination was performed on 30 patients with unstable angina (UA) with triple CAD, 34 matched patients with chronic stable angina (CSA) (20 with triple CAD and 14 with isolated left anterior descending (LAD) artery disease), and compared to 21 normals. LV cavity size was normal in all three groups. Twenty-two of 30 patients with UA had marked (>3 mm) abnormal long axis shortening during isovolumic relaxation time (IVRT), 65% of LV sites being abnormal. In CSA, minor (<3 mm) shortening during IVRT occurred in 7 patients with triple CAD, and in 5 with LAD disease, with 12% of LV sites involved in both groups, P<0.001 vs. UA. The incidence of other long axis abnormalities, including reduced extent and peak rate of shortening and lengthening as well as the delay in the onset of shortening and lengthening was increased between patients with CSA and triple CAD compared with LAD but not between the two groups of patients with triple CAD, CSA and UA. Transmitral E/A ratio was also reduced in the two groups with triple vessel disease, CSA and UA. Thus, the incidence of minor long axis abnormalities is similar in CSA and UA and is related to the severity of CAD. However, abnormal shortening during IVRT is more severe and generalised in UA but not in CSA with triple vessel disease. We suggest that these abnormalities of wall motion bear a close relation to the development of instability within the setting of CAD. (C) 1997 Elsevier Science Ireland Ltd.
引用
收藏
页码:37 / 45
页数:9
相关论文
共 14 条
[1]   ANGIOGRAPHIC MORPHOLOGY AND THE PATHOGENESIS OF UNSTABLE ANGINA-PECTORIS [J].
AMBROSE, JA ;
WINTERS, SL ;
STERN, A ;
ENG, A ;
TEICHHOLZ, LE ;
GORLIN, R ;
FUSTER, V .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1985, 5 (03) :609-616
[2]   THE STUNNED MYOCARDIUM - PROLONGED, POST-ISCHEMIC VENTRICULAR DYSFUNCTION [J].
BRAUNWALD, E ;
KLONER, RA .
CIRCULATION, 1982, 66 (06) :1146-1149
[3]  
COHN PF, 1980, HEART DIS, V1, P1480
[4]   THROMBOSIS AND ACUTE CORONARY-ARTERY LESIONS IN SUDDEN CARDIAC ISCHEMIC DEATH [J].
DAVIES, MJ ;
THOMAS, A .
NEW ENGLAND JOURNAL OF MEDICINE, 1984, 310 (18) :1137-1140
[5]   INTRACORONARY THROMBUS AND COMPLEX MORPHOLOGY IN UNSTABLE ANGINA - RELATION TO TIMING OF ANGIOGRAPHY AND IN-HOSPITAL CARDIAC EVENTS [J].
FREEMAN, MR ;
WILLIAMS, AE ;
CHISHOLM, RJ ;
ARMSTRONG, PW .
CIRCULATION, 1989, 80 (01) :17-23
[6]  
FUSTER V, 1981, MAYO CLIN PROC, V56, P102
[7]  
GIBSON DG, 1973, BRIT HEART J, V35, P1141
[8]  
HENEIN MY, 1993, BRIT HEART J, V69, P501
[9]  
HENEIN MY, 1997, IN PRESS HEART
[10]   REGIONAL MYOCARDIAL FUNCTIONAL AND ELECTROPHYSIOLOGICAL ALTERATIONS AFTER BRIEF CORONARY-ARTERY OCCLUSION IN CONSCIOUS DOGS [J].
HEYNDRICKX, GR ;
MILLARD, RW ;
MCRITCHIE, RJ ;
MAROKO, PR ;
VATNER, SF .
JOURNAL OF CLINICAL INVESTIGATION, 1975, 56 (04) :978-985