Does nitroglycerin responsiveness correlate with histologically intact myocardium and epicardial R waves in patients with coronary artery disease and asynergy?
Nitroglycerin-responsive asynergic areas in coronary artery disease indicate histologically intact myocardium and correlate with epicardial R waves, whereas unresponsive areas show significant fibrosis.
Histopathologic-electrographic studies of ventriculography depicted nitroglycerin responsive and unresponsive asynergic areas were performed in 25 patients. Of 29 areas, 12 improved with nitroglycerin, showing less than 10% muscle loss. Seventeen unimproved zones demonstrated significant fibrosis. Epicardial electrograms showed R waves in eight of nine improved zones. Of 11 unimproved zones, eight had Q waves. Histopathologic-electrographic data from five responders showed less than 10% muscle loss, of whom four had epicardial R waves. Six unresponsive areas had significant fibrosis, with a QS over four. Thus, nitroglycerin responsive asynergic areas are generally comprised of histologically intact myocardium and are associated with epicardial R waves.
Bodenheimer et al. (1976) studied this question.