Early and subtle abnormalities of left ventricular function in clinically stable coronary artery disease patients with normal ejection fraction

Background: It has been reported that, in the initial phase of ischemic cardiomyopathy, the earliest alterations of left ventricular function are detected during the relaxation phase. The aim of this study was to look for precocious abnormalities in the early stage of ischemic cardiomyopathy in both left ventricular systolic and diastolic phases. Methods and Results: Using simultaneous left ventricular catheterization and echo-Doppler techniques, we studied both systolic and diastolic function in 44 (37 males and 7 females, mean age 55.7 +/- 8) normotensive, clinically stable, coronary artery disease patients with normal left ventricular ejection fraction in comparison to 9 age- and sex-matched normal control subjects (7 males and 2 females, mean age 54.7 +/- 9). Mean values of E deceleration time, tau, left ventricular end-diastolic volume and pressure, and end-systolic volume and lowest diastolic pressure were significantly higher (from P < .05 to P < .01), whereas mean dP/dt/P values significantly lower (P < .05) in coronary artery disease patients than in controls. A strict relationship (P < .001) between dP/dt/P and tau, left ventricular lowest and end-diastolic pressure was found in all subjects studied. Conclusion: Early and subtle abnormalities in parameters of both systolic and diastolic function can be found in the majority of coronary artery disease patients with normal ejection fraction.