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Asynchrony in regional filling dynamics as a consequence of uncoordinated segmental contraction during coronary transluminal occlusion

  • Chapter
Quantitative Coronary and Left Ventricular Cineangiography

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

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Summary

The effects of brief periods of a major coronary artery occlusion on the global and regional peak filling rates were studied during angioplasty in 14 patients. None had had a previous myocardial infarction. High-fidelity left ventricular pressure and volume (by angiography) were obtained before, 20 and 50 seconds after the onset of transluminal coronary occlusion and shortly after the last balloon inflation. Segmental wall motion was analyzed frame-by-frame along 20 hemiaxes. Global peak filling rate decreased significantly both after 20 (−25%; p<.05) and 50 seconds (−24%; p<.05) from the onset of the occlusion. The term ∑Δt1 was defined as the sum of the absolute values of the time differences from the occurrence of global peak filling rate and the segmental peak filling rate, in 20 segments. This parameter increased significantly during both periods of transluminal occlusion (by 64%; p<.005 and by 54%; p<.005, respectively) thus indicating an asynchrony in the occurrence of regional peak filling rate. Simultaneously, the sum of time intervals between the aortic valve closure (end systole) and the occurrence of peak segmental shortening, ∑Δt2,− measured in the 20 segments, increased to a similar extent, thus demonstrating an asynchrony in segmental contraction. A significant, negative correlation was found between the global peak filling rate and both ∑Δt1 and ∑Δt2 (r = −. 68; p<.0001 and r = −.73; p<.0001, respectively). Our findings suggest that during coronary transluminal occlusion an early asynchrony in regional peak filling rate occurs which is strictly related to a delayed and asynchronous peak segmental shortening.

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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). Asynchrony in regional filling dynamics as a consequence of uncoordinated segmental contraction during coronary transluminal occlusion. 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_23

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  • DOI: https://doi.org/10.1007/978-94-009-4239-4_23

  • 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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