Left Ventricular Wall Motion During the Isovolumic Relaxation Period

Technically adequate left ventricular cineangiograms obtained in the 30 degree right anterior oblique (RAO) projection from 100 consecutive patients with chest pain were studied for the presence of left ventricular wall motion during the isovolumic relaxation period. Obstructive coronary artery disease was found in 59 and normal coronary arteries in 41 patients. Systolic contraction abnormalities were present in 52 of the 100 patients. Outward left ventricular wall motion during the isovolumic relaxation period was observed in 83 patients. This outward motion, termed segmental early relaxation phenomenon (SERP), was localized in 81. In 29 patients SERP was accompanied by a simultaneous inward motion that was apparent in the 30 degree RAO position in another part of the left ventricle. In ventricles with systolic contraction abnormalities SERP tended to occur in the normally contracting areas (25 of 39 patients). When the abnormal systolic contraction was extensive, SERP occurred infrequently (4 of 16 patients). In this group of patients with chest pain, whether or not they had coronary artery disease, outward left ventricular wall motion occurred commonly during isovolumic relaxation. It appears to be a normal variation of left ventricular relaxation.