Effect of Pacing‐Induced Tachycardia and Myocardial Ischemia on Ventricular Pressure‐Velocity Relationships in Man
作者:
John Graber,
C. Conti,
Donald Lappe,
Richard Ross,
期刊:
Circulation
(OVID Available online 1972)
卷期:
Volume 46,
issue 1
页码: 74-83
ISSN:0009-7322
年代: 1972
出版商: OVID
关键词: Vmax;Contractile element velocity;Left ventricular dP/dt;Coronary atherosclerosis;Ventricular function
数据来源: OVID
摘要:
Ventricular function was evaluated in 18 patients prior to left ventriculography and selective coronary arteriography. Simultaneous left ventricular pressure (catheter-tip manometer) and dP/dt were recorded at resting heart rates and during tachycardia induced by right atrial pacing. Pressure-velocity curves were constructed from which Vmaxand maximum measured contractile element velocity (max VCE) were obtained. Vmaxand max VCEinitially increased with pacing-induced tachycardia in 17 of the 18 patients. Eight patients developed evidence of myocardial ischemia during atrial pacing. During the period of myocardial ischemia there was a decrease in Vmaxand max VCEin all eight patients despite constant or increasing heart rate. In the 10 patients who did not develop evidence of myocardial ischemia with pacing-induced tachycardia, Vmaxand max VCEcontinued to increase or remained constant with increasing rate. Peak left ventricular dP/dt increased coincident with the onset of myocardial ischemia in six of eight patients despite a fall in Vmaxand max VCEin all eight patients during the ischemic period. A highly significant difference was demonstrated between Vmaxvalues of patients with normal ejection fractions and patients with low ejection fractions, both at rest and during pacing-induced tachycardia.
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