Detection of diastolic left ventricular function abnormalities in patients with coronary artery disease and normal systolic function

We angiographically calculated left ventricular (LV) filling in 50 patients, all of whom had normal systolic LV function and 21 (42%) of whom had coronary systolic LV function and 21 (42%) of whom had coronary artery disease. Five volume determinations were made: at end systole (ESV), first third (DV 1/3, half (DV 1/2), and second third of diastole (DV 2/3), and at the end of diastole (EDV). To assess different modalities of filling, we calculated filling fractions in the first third (FF 1/3) as the ratio of volume filled in the first third diastole (DV 1/3-ESV) over total diastolic filling (EDV-ESV). Similar filling fractions (FF) were calculated at half (FF 1/2), second third (FF 2/3), and last third (FF 3/3) of diastole. We found significant differences between normal and coronary artery disease patients as follows: FF 1/3: 37.4 +/- 14.9 versus 23.8 +/- 11.9%, respectively (p less than 0.002); FF 1/2: 58.6 +/- 14.7 versus 45.3 +/- 15.1% (p less than 0.005); FF 2/3: 33.8 +/- 15.2 versus 39.0 +/- 10.4% (NS), and differences in the opposite direction in the FF 3/3: 28.8 +/- 15.2 versus 37.2 +/- 11.9% (p less than 0.02), respectively. We conclude that LV filling is accomplished differently in patients with coronary artery disease even if they have normal systolic function.