LEFT-VENTRICULAR FUNCTION DURING EPISODES OF SILENT AND SYMPTOMATIC MYOCARDIAL-ISCHEMIA

Transluminal coronary angioplasty (PTCA) causes transient occlusion of the coronary artery and temporary ischemia of the left ventricle. Lef t ventricular dysfunction during silent and symptomatic episodes of my ocardial ischemia during PTCA was evaluated continuously with a newly developed miniature, non-imaging scintillation probe. Parameters of le ft ventricular function were compared before and during balloon inflat ions of 60s duration: ejection fraction (EF), indices of end-systolic and end-diastolic volumes (ESV, EDV), peak ejection and peak filling r ates (PER, PFR). 13 patients (age 54+/-7.4 years) were symptomatic, 10 patients (age 61+/-8 years) were asymptomatic. Impairment of left ven tricular function during ischemia did not show any significant differe nces between the symptomatic and asymptomatic patients. It is therefor e concluded that symptomatic and asymptomatic episodes of myocardial i schemia during PTCA cause similar impairment of systolic and diastolic left ventricular function. The degree of left ventricular dysfunction during PTCA cannot be estimated on the basis of clinical symptoms.