Cineangiocardiographic Studies of the Left Ventricle in Patients with Angina Pectoris

Abstract

The findings at coronary angiography and left ventricular cineangiography were compared with clinical data in 52 cases of coronary artery disease. A semiquantitative estimation of left ventricular end-diastolic and end-systolic volumes was used, as well as the identification of local dysfunction in the left ventricular wall. The findings at ventriculography had no relation to the functional classification or the maximal physical work capacity. Thus the limiting factor is angina pectoris and not primarily changes in the left ventricular wall after infarction. Similarly, retrograde filling of stenosed arteries by collateral channels was not correlated to the degree of left ventricular dysfunction or to physical work capacity. Patients with slight to moderate coronary artery stenosis had a normal left ventricular contraction pattern, and in no instance did the electrocardiogram indicate previous myocardial infarction. On the other hand, a normal electrocardiogram as well as a normal left ventricular contraction pattern was seen with severe coronary artery stenosis. There was a fair correspondence between the localization of infarcts according to the electrocardiograms and the left ventricular angiograms. There seemed to be more false negative electrocardiographic diagnoses of posterior-than of anterior-wall infarction. It is concluded that left ventricular angiography provides anatomic and some physiological information that no other method can give. Its use with other clinical and laboratory methods adds considerably to the accuracy in diagnosis and evaluation of patients with coronary artery disease.