Cineangiocardiographic studies of the left ventricle in patients with angina pectoris.

SUMMARY The findings at coronary angiography and left ventricular cineangiography were compared with clinical data in 52 cases of coronary artery disease. A semiquantitative estimation of left ventricular end-diastolic and end-systolic volumes was used, as well as the identification of local dysfunction in the left ventricular wall. The findings at ventriculography had no relation to the functional classification or the maximal physical work capacity. Thus the limiting factor is angina pectoris and not primarily changes in the left ventricular wall after infarction. Similarly, retrograde filling of stenosed arteries by collateral channels was not correlated to the degree of left ventricular dysfunction or to physical work capacity. Patients with slight to moderate coronary artery stenosis had a normal left ventricular contraction pattern, and in no instance did the electro-cardiogram indicate previous myocardial infarction. On the other hand, a normal electrocardiogram as well as a normal left ventricular contraction pattern was seen with severe coronary artery stenosis. There was a fair correspondence between the localiza-tion of infarcts according to the electrocardiograms and the left ventricular angiograms. There seemed to be more false negative electrocardiographic diagnoses of posterior-than of anterior-wall infarction. It is concluded that left ventricular angiography provides anatomic and some physiological information that no other method can give. Its use with other clinical and laboratory methods adds considerably to the accuracy in diagnosis and evaluation of patients with coronary artery disease. Additional Indexing Words: Coronary angiography Left ventricular aneurysm Collateral coronary arteries Physical work capacity ECG in coronary artery disease Myocardial infarction Left ventricular dysfunction Left ventricular volume CORONARY ANGIOGRAPHY has become an accepted and useful method for evaluation of patients with coronary artery disease. Angiography provides information on the anatomy of the coronary arteries but gives only limited information on the circulation in the myocardium and the functional state of the myocardium. Therefore we included cineangiography of the left ventricle in the preoperative studies of our patients with From the Departments of Diagnostic Radiology 868 angina pectoris in an attempt to obtain a better general evaluation of these patients and particularly a better selection of suitable candidates for revascularization operations on the myocardium. Methods Group Studied We now routinely perform left ventricular as well as coronary angiography on all patients referred to us for evaluation of angina pectoris. Patients with valvular heart disease or systemic hypertension and also most patients over 60 years of age have not been accepted for …