In patients with coronary artery disease, increased left ventricular filling pressure during angina is associated with increased LV end-diastolic volume rather than local asynergy.
Does not support asynergy as primary driver of angina-related pressure rises in CAD; hypothesis-generating for global LV dilation mechanisms.
Cases with ischemic heart disease often have increased left ventricular (LV) volume, often with asymmetric changes in the form of local asynergic areas. It has been known for several years that angina pectoris is usually accompanied by increased LV filling pressure. The authors have studied the relationship between the LV filling pressure and changes in the left ventriculogram in 34 cases with coronary artery disease. The left atrial (LA) mean pressure was used as an index of the LV filling pressure and was studied at rest and, in 26 cases, also during supine work. Coronary arteriographies were performed in all cases, as well as LV cineangiography in at least one plane. Though admittedly small, the groups were comparable with regard to age and cardiac index at rest. An increased filling pressure at a work load which caused anginal pain was mainly seen in the groups with increased LV end‐diastolic volume, and there was no difference between cases with and without local asynergy.
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Björk et al. (1971) studied this question.
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