Left ventricular a wave amplitude in patients after myocardial infarction
| Autor: | Bolling J. Feild, Charles E. Rackley, R.E. Moraski, McKamy Smith, Richard O. Russell |
|---|---|
| Rok vydání: | 1974 |
| Předmět: |
Cardiac output
medicine.medical_specialty Heart Ventricles Myocardial Infarction Diastole Blood Pressure Electrocardiography Heart Conduction System Internal medicine Humans Medicine cardiovascular diseases Myocardial infarction business.industry Stroke volume medicine.disease Elasticity Preload medicine.anatomical_structure Ventricle cardiovascular system Cardiology Ventricular pressure Regression Analysis End-diastolic volume Cardiology and Cardiovascular Medicine business Mathematics |
| Zdroj: | The American Journal of Cardiology. 33:370-377 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(74)90318-x |
| Popis: | The relations between left ventricular (LV) A wave amplitude and left ventricular dimensions, compliance, systolic function, and the size of abnormally contracting segments (ACS) of the left ventricle were examined in 42 patients studied within 1 year after acute myocardial infarction. Left ventricular A wave amplitude was measured from left ventricular pressure tracings both from zero (A0) and from pre-A wave pressures (APAP). Left ventricular compliance was calculated from left ventricular volumes obtained from biplane angiograms and the left ventricular pressure recorded immediately before angiograms. Left ventricular compliance was evaluated by three formulas: ΔV ΔP (angiographic stroke volume/left ventricular end-diastolic pressure (LVEDP) minus lowest early diastolic pressure); ΔV LV end-systolic volume ΔP ; and dV dP ED × 1/EDV/m 2 . Percent ACS was measured as the akinetic or dyskinetic length along the end-diastolic perimeter on biplane left ventricular angiograms expressed as a percentage of the total left ventricular diastolic perimeter. AO had a direct quadratic relation with APAP (r2 = 0.72), and A0 had high inverse quadratic correlations with ΔV ΔP (r2 = 0.59), δV ESV /δP (r2 = 0.63), and dV/dPED × 1/EDV/m2 (r2 = 0.72). A0 correlated directly with LVEDP (r2 = 0.76), end-diastolic volume (r2 = 0.32), LV mass (r2 = 0.22) and percent ACS (r2 = 0.36), and inversely with ejection fraction (r2 = 0.43). Seven of the 42 patients were studied by dextran infusion. Diastolic volume change (ΔVInd.-Dil.) calculated from indicator-dilution cardiac output values, left ventricular diastolic pressure change (ΔP), and A0 were obtained before infusion and after each 200 ml infusion. Values for diastolic pressure-volume slope ( ΔP ΔV Ind.-Dil. ) and A0 increased with dextran infusion in all seven patients. The ΔP ΔV Ind.-Dil. slopes had a significant direct linear relation with corresponding left ventricular A wave amplitudes. Thus, the slope of the diastolic pressure-volume curve for any ventricle, as reflected by the compliance values, is a major determinant of the increase in left ventricular A wave amplitude for a particular volume of dextran infused. In summary, increased left ventricular A wave amplitudes in patients after myocardial infarction signify a decrease in both left ventricular diastolic compliance and systolic function. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|