Author + information
- Received July 11, 1983
- Revision received December 27, 1983
- Accepted January 6, 1984
- Published online June 1, 1984.
- Paolo Marzullo, MD1,
- Oberdan Parodi, MD*,a,
- Heinrich R. Schelbert, MD, FACC* and
- Antonio L'Abbate, MD, FACC1
- ↵aAddress for reprints: Oberdan Parodi, MD, UCLA School of Medicine, Division of Nuclear Medicine, Los Angeles, California 90024.
Left and right ventricular synchrony was assessed in 15 patients with angina at rest but no previous infarction by phase analysis of equilibrium radionuclide ventriculograms. Transient thallium-201 perfusion defects were noted in all during angina at rest and coronary vasospasm was documented in nine of the patients. Radionuclide ventriculograms were performed at control, during the ischemic episodes and after intravenous isosorbide dinitrate. Left and right ventricular phase histograms were quantified by the standard deviation from the mean of the peak (SD). Left ventricular ejection fraction averaged 65 ± 11 % (mean ± standard deviation) at control, decreased in all patients during angina at rest to 49 ± 14% (p ± 0.01) and increased in all patients after isosorbide dinitrate to 66 ± 12%. However, ejection fraction during ischemia was abnormal in only nine patients and changed in two by less than 5 % from the control value. Regional wall motion abnormalities were noted in all patients during the ischemic episodes but resolved after isosorbide dinitrate administration. Control left ventricular SD was 14.5 ± 4°, increased in all patients to 22.8 ± 5° during angina at rest (p ± 0.01) and returned to control values after isosorbide dinitrate administration (14.2 ± 4°). In contrast, right ventricular SD did not significantly change during ischemia as compared with control and isosorbide dinitrate.
It is concluded that in angina at rest, a normal left ventricular ejection fraction does not exclude severe regional dysfunction; separate left and right ventricular SD is a sensitive index in detecting transient left ventricular dysfunction, and relief of ischemia is associated with rapid normalization of regional left ventricular function.
This study was supported in part by contract 82.02168.04 from the Cardiac Respiratory Project Grant, C.N.R. Institute of Clinical Physiology, Pisa, Italy and by contract DEAM03-76-SF00012 between the U.S. Department of Energy, Washington, D.C. and the University of California, Los Angeles.
- Received July 11, 1983.
- Revision received December 27, 1983.
- Accepted January 6, 1984.
- American College of Cardiology Foundation