Comparison of early systolic and holosystolic ejection phase indexes by contrast ventriculography in patients with coronary artery disease.

Abstract

To compare the discriminant ability of early systolic and holosystolic ejection phase indexes to detect abnormalities of left ventricular performance, the contrast ventriculograms of 20 control patients and 55 patients with coronary artery disease (at least 70% stenosis of 1 or more major coronary arteries) were analyzed. All subjects were studied to evaluate chest pain, and none was taking propranolol or antihypertensive drugs. Several ejection phase indexes were evaluated, using holosystole, the 1st third of systole and the 1st half of systole. In the patients with coronary disease, 14 (25%) had 1-vessel disease, 13 (24%) had 2-vessel disease and 28 (51%) had 3-vessel disease. The ejection fraction was more useful than indexes based on velocity of ejection. Ejection fraction was lower in the coronary patients than in normal subjects for holosystole (0.62 .+-. 0.14 vs. 0.70 .+-. 0.08, P < 0.01), for the 1st third of systole (0.20 .+-. 0.06 vs. 0.36 .+-. 0.06, P < 0.001) and for the 1st half of systole (0.34 .+-. 0.09 vs. 0.53 .+-. 0.10, P < 0.001). Patients [14] with coronary artery disease (25%) had a depressed holosystolic ejection fraction, 36 (65%) had a depressed 1st-half ejection fraction and 52 (94%) had a depressed 1st-third ejection fraction. Early ejection phase indexes, particularly the 1st-third ejection fraction, are evidently more useful than holosystolic indexes in identifying resting abnormalities of left ventricular function.