Vnitr Lek 1990, 36(10):937-943
[The effect of stimulated tachycardia on diastolic left ventricular filling in patients with ischemic heart disease].
- I. interní klinika LFH UK, Praha.
The authors examined 20 patients with ischaemic heart disease (IHD) by pulsed Doppler echocardiography before and after a load of stimulated tachycardia. The character of left ventricular filling depended on the blood pressure reading in a wedged position only in patients who had an elevated pressure (r = -0.65 and r = -0.81 resp. after a load for A/E, r = -0.62 and r = -0.79 after a load for DT). When the pressure is normal, it declines in a wedged position and the left ventricular filling in early diastole becomes protracted and the ratio of the atrial filling rises (A/E increased after the load p greater than 0.001, DT was protracted after the load p greater than 0.01). This change is due in particular to the protracted relaxation of the heart muscle. When the pressure is elevated in a wedged position, i.e. when the elasticity of the left ventricle declines, the rate of early filling rises and its duration is reduced. This relationship was more marked after the load (A/E after the load declined p greater than 0.01, DT after the load was shorter p greater than 0.001). Examination of the flow through the mitral orifice after a load by stimulated tachycardia makes it possible to differentiate patients with a mild and more severe affection of the left ventricle associated with IHD. It permits also prediction of an increased intraventricular pressure and this to monitor the course of the disease or to evaluate the success of treatment.
Keywords: Adult; Aged; Cardiac Pacing, Artificial; Coronary Disease /physiopathology/; Diastole; Echocardiography, Doppler; Female; Humans; Male; Middle Aged; Tachycardia /physiopathology/; Ventricular Function, Left
Published: October 1, 1990 Show citation