| Description |
Coronary artery disease has long been a subject of intensive investigation. Few studies have thoroughly examined the effects that a single lesion in the left anterior descending coronary artery, the right coronary artery, or the circumflex coronary artery has been upon the left ventricle of the human heart. The purpose of this study was to examine and compare the mean values of left ventricular global and regional wall motion in subgroups of single vessel coronary artery disease patients and in a group of normal patients. Also compared were the mean hemodynamic measurements of left ventricular and diastolic pressure, mean aortic pressure and ejection fraction of the subgroups of single vessel disease patients and the normal patient group. All patients involved in this study underwent left ventriculography and coronary arteriography. It was from these ventriculographic and left ventricular hemodynamics for each patient in the study was provided. The single vessel disease patients were sub grouped according to such clinical factors as location and severity of lesion, presence of collateral circulation, presence of previous myocardial infarction, and right or left dominance of the coronary supply system to the inferior wall of the left ventricle. To determine regional and global wall motion for each patient, the percent shortening parameter was used. The left ventricular motion was recorded on cine’ film during angiography. At end diastole and end systole, the endocardial borders of the left ventricle were traced. Percent shortening measured percent changes in the length of radii extended to the endocardial border of the ventricular wall. Regional wall motion, both deficit and compensatory, was measured on the anterior wall (radii 40-68), and the inferior wall (radii 17-32). Global wall motion was that wall motion measured over the entire ventricle (radii 17-72). The motion for each patient was judged to be compensatory if the percent shortening of a radius was greater than the mean percent shortening of the normal population at that same radius. If the percent shortening of a radius was less than the normal population’s mean percent shortening at the same radius, the wall motion at that particular point was deficit motion. Some interesting conclusions were drawn from this study. Statistically significant differences between the subgroups of single vessel disease patients and the normal patients were limited due to the wide range of ventricular wall motion in individual patients within each subgroup. For each of nine subgroups included in the analysis, the mean ventricular wall motion was not diminished unless there was total occlusion of the coronary artery. For the populations with total occlusion of a coronary artery, there was little difference in ejection fraction or ventricular wall motion between those with or without myocardial infarctions. Finally, for most subgroups with depressed ventricular wall motion in the affected wall, no trends were observed that indicated compensatory ventricular wall motion in the wall of the ventricle that was not affected by disease. |
