<Originals>Impairment of regional left ventricular diastolic filling in myocardial infarction

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Relaxation characteristics of infarcted myocardium were studied by measuring cyclic changes of both the whole left ventricular volume and regional segment length in 27 patients with old myocardial infarction (OMI) and 22 normals. The left ventricular volume was calculated by using the biplane left ventricular cineangiogram. The regional segment length was calculated by measuring the spatial length between the two points of the ramifying branch on the left coronary arteries by using biplane coronary cineangiograms. The left ventricular filling volume before atrial contraction (V_R) was significantly reduced in OMI as compared with that in normals (Normal 38±6 (mean±SD) ml/m^2 vs OMI 30±7 ml/m^2 : p<0.01), while filling volume due to atrial contraction (V_a) did not significantly differ (Normal 15±4 ml/m^2 vs OMI 17±5 ml/m^2). Stroke volume was significantly reduced in OMI as compared with normals (Normal 53±8 ml/m^2 vs OMI 47±8 ml/m^2 : p<0.05). The lengthening of the segmental wall during diastole before atrial contraction (%ΔL_R) in the infarcted portion was 5.0±2.9% which was also significantly less than that in the non-infarcted portion (9.6±4.2%). The extent of lengthening by atrial contraction (%ΔL_a) did not differ between the two portions (non-infarcted portion 3.8±1.1% vs infarcted portion 3.5±1.2%). This study suggests that an increased stiffness of the infarcted myocardium may lead to a reduction of diastolic expansion before atrial contraction which is a major cause of decreased stroke volume in OMI.
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<Originals>Impairment of regional left ventricular diastolic filling in myocardial infarction

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