For the purpose of the estimation of the coronary artery stenosis influence on the left ventricular (LV) diastolic function we performed this investigation. We analyzed coronary artery catheterization results in 84 patients with coronary artery disease. We included into analysis left main coronary artery (LMA), left anterior descendent artery (LAD), circumflex artery (CA), obtuse marginal artery (OMA), diagonal artery (DA), right coronary artery (RCA), posterior descending artery (PDA). All coronary arteries stenoses data were subdivided onto five levels: 1) less then 30% of narrowing - insignificant stenosis; 2) 31-50 % of narrowing - mild stenosis; 3) 51 - 70 % of narrowing - moderate stenosis; 4) 71-90 % of narrowing - severe stenosis; and 5) more then 90 % of narrowjng - sub-occlusion and occlusion af the coronary artery branches. Usual indexes of the transmitral blood flow (E, L, E/A, IVRT, Tdecel). Resiliency modulus (RM) and stiffness index (SI) were calculated, using LV chamber systolic and diastolic dimensions and some Doppler indexes. We estimated LV diastolic function indexes at the each level of the isolated coronary stenosis of the each coronary artery branch. We have found that there were multiple changes of the diastolic blood flow due to different places and degrees of the coronary artery stenosis. Even insignificant and mild degrees of the coronary artery narrowing caused rising of the myocardial stiffness and diastolic dysfunction (LVDD). Moderate degree of the LMA, LAD, PDA, DA and RCA stenoses and occlusion of the OMA provoked the I-st type of the diastolic dysfunction. Mild degree of the CA, DA, PDA; severe stenosis of the CA, occlusion and sub-occlusion of the DA were usually associated with the II-nd type of the LVDD. Pseudo-normal transmitral blood flow were found in the patients with occlusion and sub-occlusion of the CA, LAD, RCA. Among all patients we revealed some clinical cases with suppression of the early and late transmitral blood flow. All of these patients had very severe stenoses of the main coronary branches. The most harmful combinations of the coronary stenoses in terms of diastolic function deterioration were found in the patients with moderate narrowing of the CA plus LAD, CA plus OMA, LAD plus OMA, PDA plus OMA. Our data indicate that even mild degrees of the coronary stenosis are accompanied by LVDD. The types and degree of the diastolic function disturbances depend on the place, severity and combination of the coronary stenosis. Only a small part of the investigated patients had a benefit from the coronary revascularisation in terms of the diastolic function. Most of the patients had an elevated stiffness, diminished compliance and lowered early LV filling 3, 12 and 24 month after the revascularisation. It is clear that coronary stenosis cause some irreversible changes in the myocardium and the additional therapeutic efforts are needed for the LV function restoration.

Original languageEnglish
Pages (from-to)A37
JournalHeart
Volume83
Issue numberSUPPL. 2
StatePublished - Jun 2000

    Scopus subject areas

  • Cardiology and Cardiovascular Medicine

ID: 87874304