COMPARISON OF LEFT-VENTRICULAR FUNCTION AND VOLUMES DURING TRANSESOPHAGEAL ATRIAL-PACING COMBINED WITH 2-DIMENSIONAL ECHOCARDIOGRAPHY IN PATIENTS WITH SYNDROME-X, ATHEROSCLEROTIC CORONARY-ARTERY DISEASE, AND NORMAL SUBJECTS

Nine patients with syndrome X were compared with 2 groups of patients known to have coronary artery disease (CAD) (8 patients who developed regional wall motion abnormalities [group ECHO+] and 6 patients who sh owed only ST depression at echo-pacing [group ECG+]) and with 6 health y volunteer control subjects. Left ventricular function at rest was no rmal in all patients. End-diastolic and end-systolic volumes (ml/m(2)) and election fraction were calculated at baseline and at peak of echo -pacing using a Simpson's biplane method. No regional wall motion abno rmalities were observed during the echo-pacing in patients with syndro me X or in the volunteers. End-diastolic volume decreased in patients with syndrome X, in the volunteers (from 47 +/- 11 to 30 +/- 12 and fr om 72 +/- 7 to 38 +/- 6, respectively, p < 0.01 for both), and in ECG patients (from 48 +/- 10 to 33 +/- 6, p < 0.05), whereas it did not c hange in ECHO+ patients. End-systolic volume decreased in patients wit h syndrome X and in the volunteers (from 17 +/- 5 to 11 +/- 4 and from 28 +/- 6 to 16 +/- 4, respectively, p < 0.01 forboth), whereas it did not change or else slightly increased in patients with CAD (from 18 /- 10 to 16 +/- 5 For ECG+ patients and from 19 +/- 5 to 24 +/- 9 for ECHO+ patients, p = NS for both), regardless of whether regional wall motion abnormalities appeared. Ejection fraction decreased in ECG+ and ECHO+ patients (from 64 +/- 12 to 52 +/- 11 and from 62 +/- 9 to 44 /- 13, respectively, p < 0.01 for both), whereas it did not change in patients with syndrome X and in the volunteers from 64 +/- 8 to 61 +/- 8 and from 61 +/- 7 to 58 +/- 7, respectively, p = NS for both). Duri ng echo-pacing in syndrome X patients no regional wall motion was dete cted. Left ventricular volumes and election fraction showed the same p atterns of variation in these patients as they did in the healthy cont rol subjects, in contrast with those patients with CAD, whether or not regional wall motion abnormalities appeared in the latter. (C) 1997 b y Excerpta Medica, Inc.