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Regional Diastolic Dysfunction in Coronary Artery Disease: Clinical and Therapeutic Implications

  • Hubert Pouleur
  • Michel F. Rousseau

Abstract

Alterations in left ventricular diastolic function, such as reduction in the rate of pressure-decrease during isovolumic relaxation, impaired rate of rapid filling, or upward shift of the diastolic pressure-volume relation, are found in most patients with coronary artery disease [1–9]. These abnormalities are particularly severe during angina [2, 8], but they are also frequently evident in the absence of clinical signs of ischemia [3–6, 9, 10]. It has also been shown that these altered diastolic properties may be improved by several therapeutic interventions [6, 9–11].

Keywords

Diastolic Function Exercise Duration Left Ventricular Diastolic Function Peak Filling Rate Myocardial Relaxation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Papapietro SE, Coghlan HC, Zissermann D, et al (1979). Impaired maximal rate of left ventricular relaxation in patients with coronary artery disease and left ventricular dysfunction. Circulation 59: 984–991.PubMedGoogle Scholar
  2. 2.
    McLaurin LP, Rolett EL, Grossman W (1973). Impaired left ventricular relaxation during pacing-induced ischemia. Am J Cardiol 32: 751–757.PubMedCrossRefGoogle Scholar
  3. 3.
    Rousseau MF, Veriter C, Detry JMR, et al (1980). Impaired early left ventricular relaxation in coronary artery disease. Effects of intracoronary nifedipine. Circulation 62: 764–772.Google Scholar
  4. 4.
    Rousseau MF, Pouleur H, Detry JMR, Brasseur LA (1981). Relationship between changes in left ventricular inotropic state and relaxation in normal subjects and in patients with coronary artery disease. Circulation 64: 736–743.PubMedCrossRefGoogle Scholar
  5. 5.
    Bonow RO, Bacharach SL, Green MV, et al (1981). Impaired left ventricular diastolic filling in patients with coronary artery disease: Assessment with radionuclide cineangiography Circulation 64: 315–323.Google Scholar
  6. 6.
    Bonow RO, Vitale DF, Bacharach SL, et al (1985). Asynchronous left ventricular regional function and impaired global diastolic filling in patients with coronary artery disease: Reversal after coronary angioplasty. Circulation 71: 297–307.Google Scholar
  7. 7.
    Reduto LA, Wickmeyer WJ, Young JB, et al (1981). Left ventricular diastolic performance at rest and during exercise in patients with coronary artery disease: Assessment with first-pass radionuclide angiography. Circulation 63: 1228–1237.Google Scholar
  8. 8.
    Mann T, Goldberg S, Mudge GH, Grossman W (1979). Factors contributing to altered left ventricular diastolic properties during angina pectoris. Circulation 59: 14–20.PubMedGoogle Scholar
  9. 9.
    Pouleur H, Rousseau MF, van Eyll C, et al (1986). Impaired regional diastolic distensibility in coronary artery disease: Relations with dynamic left ventricular compliance. Am Heart J. 112: 721–728.Google Scholar
  10. 10.
    Pouleur H, Rousseau MF, van Eyll C, Charlier AA (1984). Assessment of regional left ventricular relaxation in patients with coronary artery disease: Importance of geometric factors and changes in wall thickness. Circulation 69: 696–702.Google Scholar
  11. 11.
    Lorell BH, Turi Z, Grossman W (1981). Modification of left ventricular response to pacing tachycardia by nifedipine in patients with coronary artery disease. Am J Med 71: 667–675.PubMedCrossRefGoogle Scholar
  12. 12.
    Ludbrook PA, Byrne JD, Tiefenbrunn AJ (1981). Association of asynchronous protodiastolic segmental wall motion with impaired left ventricular relaxation Circulation 64: 1201–1211.Google Scholar
  13. 13.
    Kumada T, Karliner J, Pouleur H, et al (1979). Effects of acute coronary occlusion on early ventricular diastolic events in conscious dogs. Am J Phsiol 237: H542 - H549.Google Scholar
  14. 14.
    Ross J Jr (1979). Acute displacement of the diastolic pressure-volume curve of the left ventricle: Role of the pericardium and the right ventricle. Circulation 59: 32–37.PubMedGoogle Scholar
  15. 15.
    Serizawa T, Carabello BA, Grossman W (1980). Effect of pacing-induced ischemia on left ventricular diastolic pressure-volume relations in dogs with coronary stenoses. Circ Res 46: 430–439.PubMedGoogle Scholar
  16. 16.
    Paulus WJ, Serizawa T, Grossman W (1982). Altered left ventricular diastolic properties during pacing-induced ischemia in dogs with coronary stenoses: Potentiation by caffeine. Circ Res 50: 218–227.Google Scholar
  17. 17.
    Bourdillon PD, Lorell BH, Mirsky I, et al (1983). Increased regional myocardial stiffness of the left ventricle during pacing-induced angina in man. Circulation 67: 316–323.PubMedCrossRefGoogle Scholar
  18. 18.
    Sasayama S, Nonogi H, Miyazaki S, et al (1985). Changes in diastolic properties of the regional myocardium during pacing-induced ischemia in human subjects. J Am Coll Cardiol 5: 599–606.PubMedCrossRefGoogle Scholar
  19. 19.
    Gertz EW, Wisneksi JA, Neese R, et al (1981). Myocardial lactate metabolism: evidence of lactate release during net chemical extraction in man. Circulation 63: 1273–1279.PubMedCrossRefGoogle Scholar
  20. 20.
    Wisneski JA, Gertz EW, Neese RA, et al (1985). Dual carbon-labeled isotope experiments using D-(6-t4C)glucose and L-(1, 2, 3~ 3C3) lactate: A new approach for investigating human myocardial metabolism during ischemia. J Am Coll Cardiol 5: 1138–1146.Google Scholar
  21. 21.
    Rousseau MF, Vincent MF, Van Hoof F, et al (1984). Effects of nicardipine and nisoldipine on myocardial metabolism, coronary blood flow and oxygen supply in angina pectoris. Am J Cardiol 54: 1189–1194.PubMedCrossRefGoogle Scholar
  22. 22.
    Mudge GH Jr, Mills RM, Taegtmeyer H, et al (1976). Alterations of myocardial amino-acid metabolism in chronic ischemic heart disease. J Clin Invest 58: 1185–1192.PubMedCrossRefGoogle Scholar
  23. 23.
    Braunwald E, Kloner RA (1982). The stunned myocardium: Prolonged, postischemic ventricular dysfunction. Circulation 66: 1146–1149.Google Scholar
  24. 24.
    Suga H (1979). External mechanical work from relaxing ventricle. Am J Physiol 236: H494 - H497.PubMedGoogle Scholar
  25. 25.
    van Eyll C, Pouleur H, Charlier AA, et al (1984). Interest of quantitative diastolic regional wall motion analysis in ischemic heart disease. In Computers in Cardiology. Salt Lake City: IEEE Computer Society, pp 219–222.Google Scholar
  26. 26.
    Ishida Y, Meisner JS, Tsujioka K, et al (1986). Left ventricular filling dynamics: Influence of left ventricular relaxation and left atrial pressure. Circulation 74: 187–196.Google Scholar
  27. 27.
    McKay RG, Aroesty JM, Heller GV, et al (1984). The pacing stress test reexamined: Correlation of pacing-induced hemodynamic changes with the amount of myocardium at risk. J Am Coll Cardiol 3: 1469–1481.Google Scholar
  28. 28.
    De Kock M, Melin JA, Pouleur H, Rousseau 32. MF (1986). Alterations in myocardial metabolism and function at rest in stable angina pectoris: Relations with the amount of exercise- 33. induced thallium-201 perfusion defect. Catheterization and Cardiovascular Diagnosis 12: 391–398.Google Scholar
  29. 29.
    Grossman W, Barry WH (1980). Diastolic pressure-volume relations in the diseased heart. Fed Proc 39: 148–155.PubMedGoogle Scholar
  30. 30.
    Rodeheffer RJ, Gerstenblith G, Becker LC, et al (1984). Exercise cardiac output is maintained with advancing age in healthy human subjects: Cardiac dilatation and increased stroke volume compensate for a diminished heart rate. Circulation 69: 203–213.Google Scholar
  31. 31.
    Melin JA, Piret LJ, Vanbutsele RJM, et al (1981). Diagnostic value of exercise electrocardiography and thallium myocardial scintigraphy in patients without previous myocardial infarction: a Bayesian approach. Circulation 63: 1019–1024.PubMedCrossRefGoogle Scholar
  32. 32.
    Nuttall A, Snow HM (1982). The cardiovascular effects of ICI 118, 587: A β1-adrenoceptor partial agonist. Br J Pharmacol 77: 381–388.PubMedGoogle Scholar
  33. 33.
    Rousseau MF, Pouleur H, Vincent MF (1983). Effects of a cardioselective beta1 partial agonist ( Corwin) on left ventricular function and myocardial metabolism in patients with previous myocardial infarction. Am J Cardiol 51: 1267–1274.Google Scholar
  34. 34.
    Bonow RO, Leon MB, Rosing DR, et al (1981). Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with artery disease. Radionuclide angiographic studies at rest and during exercise. Circulation 65: 1337–1350.Google Scholar
  35. 35.
    Monrad ES, McKay RG, Bairn DS, et al (1984). Improvement in indexes of diastolic performance in patients with congestive heart failure treated with milrinone. Circulation 70 (6): 1030–1037.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing 1987

Authors and Affiliations

  • Hubert Pouleur
  • Michel F. Rousseau

There are no affiliations available

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