Left ventricular function in coronary disease: serial studies in the absence of myocardial infarction or coronary artery surgery

Abstract

Fifteen patients with coronary artery disease underwent repeat cardiac catheterization (R) 7-45 months (mean 19.4) after the initial study (I) because of increasing angina. No patient sustained a myocardial infarction between I and R or underwent coronary artery surgery. Left ventricular function exhibited variability between the two studies with 6 patients demonstrating deterioration in ejection fractions (I = 65.6 = +/- 14.0 vs R = 50.5 +/- 15.4 p less than 0.01); 5 patients had a slight increase and the remainder showed no change. Changes in left ventricular volumes were not significant. Eight patients demonstrated progression of their coronary artery disease. The remaining 7 patients did not demonstrate progression. All 8 patients with progression and 5 of 7 patients without coronary artery progression demonstrated left ventricular asynergy. There was no difference in left ventricular function in the group of patients with coronary progression vs. those without progression. We conclude that changes in LV function are variable in patients with coronary artery disease in the absence of myocardial infarction or coronary surgery, and the relationship to progression of coronary artery disease or increasing angina is unclear.