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Effect of coronary occlusion during percutaneous transluminal angioplasty in man on left ventricular chamber stiffness and regional diastolic pressure-radius relations

  • Chapter
Book cover Quantitative Coronary and Left Ventricular Cineangiography

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 51))

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Summary

The effect of repeated (3 to 10) and transient (15 to 75 sec) abrupt coronary occlusions on the global and regional chamber stiffness was studied in 9 patients undergoing angioplasty (PTCA) of a single proximal left anterior descending coronary artery stenosis. The left ventricular high fidelity pressure and volume relation was obtained prior to and after the procedure, as well as during coronary occlusion, after 20 seconds (N = 9) and after 50 seconds (N = 5). During ischemia, there was an upward shift of the pressure-volume relation. The nonlinear simple elastic constant of chamber stiffness increased from 0.0273 ± 0.017 (mean ± s.d.) pre-PTCA to 0.0621 ±0.026 after 20 sec of occlusion (p<0.05) and to 0.0605 ± 0.015 after 50 sec of occlusion (p<0.01). In 6 patients, the post- PTCA value remained higher than the control value, but at the group level the mean value (0.0529 ± 0.037) was not statistically different. The regional stiffness was determined from the changes in the length of 6 segmental radii during diastole, from the lowest diastolic to the end-diastolic pressure. The regional constant of elastic stiffness was unaffected in the nonischemic zone. In the adjacent and ischemic zones, the regional stiffness was increased during occlusion (p<0.05). These regional abnormalities in diastolic function persisted at the time of post-PTCA measurements, 12 minutes after the end of the procedure. This suggests that recovery of a normal diastolic function after repeated ischemic injuries is delayed after restoration of a normal blood flow and systolic function.

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Authors and Affiliations

  1. Department of Cardiology (Chief: P.G. Hugenholtz, M.D., F.A.C.C.) Thoraxcenter, Erasmus University, and University Hospital Dijkzigt, Rotterdam, The Netherlands

    J. H. C. Reiber Ph.D., P. W. Serruys M.D. & C. J. Slager M.Sc.

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  1. J. H. C. Reiber Ph.D.
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  2. P. W. Serruys M.D.
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  3. C. J. Slager M.Sc.
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© 1986 Martinus Nijhoff Publisher, Dordrecht

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Reiber, J.H.C., Serruys, P.W., Slager, C.J. (1986). Effect of coronary occlusion during percutaneous transluminal angioplasty in man on left ventricular chamber stiffness and regional diastolic pressure-radius relations. In: Quantitative Coronary and Left Ventricular Cineangiography. Developments in Cardiovascular Medicine, vol 51. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4239-4_15

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  • DOI: https://doi.org/10.1007/978-94-009-4239-4_15

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8382-9

  • Online ISBN: 978-94-009-4239-4

  • eBook Packages: Springer Book Archive

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