Recovery of systolic and diastolic left ventricular function after a 60-second coronary arterial occlusion during percutaneous transluminal coronary angioplasty for angina pectoris.

Recovery of global and regional systolic and global diastolic left ventricular (LV) function was examined after 60 seconds of coronary arterial occlusion in 9 men without myocardial infarction undergoing elective percutaneous transluminal coronary angioplasty. Hemodynamic and electrocardiographic recordings and a simultaneous digital subtraction LV angiogram in the 30 degree right anterior oblique view were performed before coronary occlusion, after 60 seconds of the first 2 occlusions and at 20, 40, 60 and 90 seconds of reperfusion. Diastolic pressure-volume relations paired the digital volumes to corresponding high-fidelity analog pressures. Similar and significant depression of global ejection fraction, percent radial shortening in the jeopardized region, maximal positive dP/dt and significant elevation of LV end-diastolic pressure and ST segments occurred with each 60-second coronary occlusion. All of these variables except LV end-diastolic pressure returned to control levels within 40 seconds of reperfusion. Significant elevation of the diastolic pressure-volume relation occurred with each coronary occlusion and progressively diminished to control values with 60 seconds of reperfusion. No statistically significant difference in any measurement occurred between the 2 occlusions and reperfusions at any point. This study shows that similar and significant depression and time course of recovery of global and regional systolic and global diastolic LV function accompanied each 60-second coronary occlusion with recovery of systolic function preceding recovery of diastolic function.

Duke Scholars

Author Kenneth Gregory Morris Medicine, Cardiology