Do patients with coronary artery disease have systolic and diastolic abnormalities of the left ventricle compared to controls?
Patients with coronary artery disease exhibit abnormalities in diastolic compliance and contractile performance even without significant increases in left ventricular end-diastolic volume.
Left ventricular volume and circumference were calculated from cineangiocardiograms at 60 frames/sec in 15 patients with arteriographically proven coronary artery disease (CAD) and five control subjects. The patients with CAD had no mitral regurgitation and had an average end-diastolic volume equivalent to that reported by others in normal subjects and to that of the control group. The average end-diastolic pressure was higher in CAD and was often abnormal, despite lack of increase in enddiastolic volume. The ejection was lower in the CAD group as was the extent of circumferential fiber shortening. Maximal and mean rates of fiber shortening correlated positively with ejection fraction and were low in some individuals with CAD. We conclude that our patients without significant increase in left ventricular enddiastolic volume had abnormalities of diastolic compliance and contractile performance.
Bristow et al. (1970) studied this question.