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November 1, 1972CirculationOpen Access

Echocardiographic Study of the Abnormal Motion of the Posterior Left Ventricular Wall during Angina Pectoris

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Why the study?

How does the motion of the posterior left ventricular wall change during angina pectoris compared to rest and normal subjects?

Population

30 normal subjects and 9 patients with angina pectoris

Comparison

Exercise and observation during anginal episodes vs Normal subjects during exercise, and patients'…

Design

Cohort

Authors

AFAlan M. FogelmanUniversity of Southern CaliforniaAAAbdul S. AbbasiUniversity of California, Los AngelesMPMorton Lee PearceWest Los Angeles College

Discussion

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Implication

Diastolic velocity slowing during angina may mark reversible ischemia; hypothesis-generating for tissue Doppler in acute evaluation, pending prospective validation.

Key Points

  • To assess changes in the motion and velocities of the posterior left ventricular endocardium during episodes of exercise-induced angina pectoris using echocardiography.
  • Recorded echocardiographic waves from the posterior left ventricular endocardium in 30 healthy control subjects (20 evaluated during exercise) and in 9 patients during 13 anginal episodes.
  • Measured resting, exercise, and anginal maximal and mean systolic velocities (SEVM, SEV), systolic excursion (SEE), and maximal and early diastolic velocities (DEVM, DEV).
  • Patients with angina exhibited significantly lower baseline resting DEVM (15 ± 4 vs. 18 ± 3 cm/sec, P < 0.025) and DEV (8.4 ± 0.8 vs. 9.4 ± 1.7 cm/sec, P < 0.025) compared to healthy controls.
  • During anginal attacks, patients experienced severe slowing of DEVM (8.2 ± 3.2 cm/sec, P < 0.001) and DEV (5.7 ± 2.2 cm/sec, P < 0.001), while systolic velocities and excursion did not differ significantly from rest.
  • Endocardial wall motion abnormalities completely normalized within five minutes following the disappearance of chest pain and ST-segment depression.

Structured PICO

How does the motion of the posterior left ventricular wall change during angina pectoris compared to rest and normal subjects?

P
Population
30 normal subjects and 9 patients with angina pectoris
I
Intervention
Exercise and observation during anginal episodes
C
Comparator
Normal subjects during exercise, and patients' own resting baseline
O
Outcome
Echocardiographic measurements of posterior left ventricular wall motion (maximal systolic endocardial velocity [SEVM], mean systolic endocardial velocity [SEV], systolic endocardial excursion [SEE], maximal diastolic endocardial velocity [DEVM], and mean early diastolic endocardial velocity [DEV])surrogate

Echocardiography demonstrates significant slowing of early diastolic posterior left ventricular wall motion during anginal episodes, which normalizes after pain resolution.

Cite This Study

Fogelman et al. (1972) studied this question.

synapsesocial.com/papers/6a154e9b79ff98d0de4e6af7https://doi.org/10.1161/01.cir.46.5.905

Topics

Echocardiography
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Systolic and Diastolic Abnormalities of the Left Ventricle in Coronary Artery Disease1970 · 165 citations
  2. 2Maximal rate of pressure fall (peak negative dP/dt) during ventricular relaxation1972 · 133 citations
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  5. 5Ultrasonic Measurement of Left Ventricular Wall Motion in Acute Myocardial Infarction1971 · 51 citations