DETERMINANTS OF REGIONAL MYOCARDIAL-FUNCTION IN PATIENTS WITH CHRONICSIGNIFICANT CORONARY STENOSIS OR OCCLUSION

Background Our aim was to study the effect of collateral flow, stenosi s severity, antegrade flow, and location of the lesion on regional myo cardial function in patients with chronic left anterior descending (LA D) coronary artery disease. Methods and Results Seventy-four patients who underwent coronary angiography and ventriculography were divided i nto three groups: group A (n = 9), patients with normal coronary angio gram and ventriculogram; group B (n = 32), patients with LAD stenosis >75%; and group C, 33 patients with LAD occlusion. The effect of colla teral flow, stenosis severity, location, and antegrade flow on regiona l myocardial function in the LAD territory was studied. Regional funct ion was impaired in both groups B and C. In group B, univariate analys is confirmed that antegrade flow had a significant effect on regional function (p < 0.02). With the use of multiple regression, none of the other variables had an additional independent effect. In group C, no s ignificant correlation was found between regional function and the stu dy variables by univariate analysis; however, multiple regression reve aled a significant correlation between.anterobasal function, the lesio n sire (p = 0.01), and collateral flow (p = 0.02). Conclusions In pati ents with LAD stenosis, antegrade flow has the strongest effect on reg ional myocardial function, with no additional effect of visible collat erals. In patients with LAD occlusion, both angiographic collateral fl ow and the site of the lesion have a significant effect on the functio n of the anterobasal area.