Document Detail


Mechanism of increase in left ventricular end-diastolic pressure after contrast ventriculography in patients with coronary artery disease.
MedLine Citation:
PMID:  6869175     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elevation in left ventricular (LV) end-diastolic pressure (EDP) after contrast ventriculography (CV) has been proposed as a form of stress intervention in patients with coronary artery disease (CAD). The mechanism of this change has not been delineated. Accordingly, we performed two studies in CAD patients. In study 1 (n = 10), CV was repeated 3 minutes after an initial study. LVEDP rose from 14.9 +/- 6.6 mm Hg prior to the first ventriculogram to 26.9 +/- 10.8 mm Hg 3 minutes after the first ventriculogram (p less than 0.05) and immediately prior to the repeat CV (performed to evaluate the changes in volume produced by the first ventriculogram). In four patients with LV micromanometer pressures, the entire diastolic pressure-volume relation was shifted upward. LV ejection fraction (EF) and end-diastolic volume (EDV), peak LV pressure, and peripheral vascular resistance were unchanged at the time of repeat CV, and there was no correlation between the change in EDP and any of these variables. In study 2 (n = 6), gated radionuclide angiography was performed prior to and at minutes 2 to 7 after CV as were measurements of LV and right ventricular (RV) pressures. While both LV and RV EDP rose following contrast ventriculography, LV and RV EDV and EF were unchanged. We conclude that alterations in LVEDP after CV are unrelated to changes in LV or RV EDV and are most likely mediated by a decrease in myocardial compliance.
Authors:
R Slutsky; C Higgins; D Costello; W Hooper; M M LeWinter
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  106     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1983 Jul 
Date Detail:
Created Date:  1983-08-11     Completed Date:  1983-08-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  107-13     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure / drug effects*
Contrast Media / adverse effects*
Coronary Disease / radiography*
Diastole
Hemodynamics / drug effects
Humans
Male
Middle Aged
Stroke Volume / drug effects
Time*
Time Factors*
Vascular Resistance / drug effects
Grant Support
ID/Acronym/Agency:
5K09HL00201-05/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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