Document Detail


Systolic and diastolic alterations of left ventricular function: prevalence in ischaemic heart disease and importance in the management of individual patients.
MedLine Citation:
PMID:  2968909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Myocardial perfusion and contractile performance are strictly interrelated. Conclusive experimental data show that changes in perfusion cause immediate changes in function, and conversely, that changes in contraction affect both total and regional myocardial blood flow. In ischaemic heart disease, both transient and permanent changes in global and/or regional left ventricular (LV) function have been described. In myocardial ischaemia, an impairment of LV relaxation, as indicated by a reduction of negative dP/dt, is the first appreciable haemodynamic event. When ischaemia is sustained, impairment of LV contraction follows, as indicated by a drop of positive dP/dt, reduction of systolic LV pressure, rise of end-diastolic LV pressure. Unrestricted reperfusion, as in experimental coronary occlusion and in Prinz-Metal angina, is associated with a transient rebound in regional systolic function. Spontaneous and/or induced changes of regional ventricular function provide relevant information for the management of the individual patient. In PTCA candidates monitoring regional contractile performance by mono and two-dimensional echocardiography during dypiridamole infusion has proven to be a sensitive and specific test for (1) assessing the haemodynamic significance of a coronary stenosis in patients with single-vessel disease, (2) identifying the 'culprit' lesion in patients with multiple-vessel disease. During PTCA, right and left ventricular function assessed by radionuclide angiography both at rest and during atrial pacing appears to be a sensitive method for the immediate evaluation of the efficacy of the procedure.
Authors:
M Marzilli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  9 Suppl F     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-08-18     Completed Date:  1988-08-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1-4     Citation Subset:  IM    
Affiliation:
Institute of Clinical Physiology, Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon
Coronary Disease / physiopathology*,  therapy
Diastole
Echocardiography
Heart / physiopathology*
Hemodynamics
Humans
Myocardial Contraction
Systole

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


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