Hemodynamic Evaluation of Ischemic Heart Disease

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Right and left heart catheterizations were performed on 53 patients with myocardial infarction (10 hours to 7 years after the initial attacks). Twenty-five patients with angina and without infarction as well as 7 patients with pulmonary diseases were evaluated with the same methods.Right atrial, pulmonary arterial and pulmonary capillary pressures were elevated in the infarction group compared to the angina and pulmonary patients. However, pulmonary capillary pressure was most sensitive to detect the left ventricular dysfunction due to myocardial infarction. Left ventricular stroke work index, maximal dp/dt, and mean circumferential shortening rate were significantly lower in infarction patients compared to angina patients.The left ventricular dysfunction of infarction patients was mostly encountered in acute period and several years after the initial attacks and was rare between these periods.Coronary circulation was evaluated with N2O method, however, there was no significant difference in the coronary circulatory disturbances of infarction and angina groups.The prognosis of the patients was evaluated in terms of pulmonary arterial wedge pressure, left ventricular mean circumferential shortening rate and stroke work index. Seventy-five per cent of those who showed abnormal values in all of these parameters died during the follow-up period of 5-10 years after the measurements. Left ventricular stiffness was assessed with left ventricular diastolic pressure-volume relationship and the stiffer left ventricle showed the worse prognosis.
International Heart Journal刊行会の論文

Hemodynamic Evaluation of Ischemic Heart Disease

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