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Ann Thorac Surg 1975;20:127-135
© 1975 The Society of Thoracic Surgeons

Articles

Assessment of Ventricular Function in Coronary Artery Disease Using Nitroglycerin and Computerized Analysis of Left Ventriculograms

Hiram W. Marshall, M.D., Paul Clayton, Ph.D., Paul Urie, M.S., Homer Warner, M.D., Harold V. Liddle, M.D.*

From the Department of Biophysics and Bioengineering, University of Utah College of Medicine and Latter-Day Saints Hospital, Salt Lake City, Utah.

* Address reprint requests to Dr. Liddle, Latter-Day Saints Hospital, 325 Eighth Ave., Salt Lake City, Utah 84103.

The ability to predict if abnormalities in regional wall motion are reversible would assist in selecting patients for aortocoronary bypass operation. This study shows that asynergic areas of the ventricle may be reversed by nitroglycerin. Thirty-four asynergic areas in 30 patients with coronary artery disease were studied before and after administration of nitroglycerin. Nineteen patients with previous infarction, diagnostic Q waves in their electrocardiogram, and akinetic areas in the left ventricle had no change in their akinetic areas after nitroglycerin administration. Nine of these patients did show increased motion in other hypokinetic areas of the myocardium. Five of 11 patients with no evidence of previous infarction showed a dramatic improvement in akinetic areas after nitroglycerin, while of the remaining 6, 5 snowed mild improvement. This illustrates that recoverable asynergic areas may be recognized by nitroglycerin.






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