Regional left ventricular systolic function in patients with segmental early relaxation and normal coronary arteries

The purpose of the study was to determine whether regional differences of left ventricular systolic function exist in patients with normal coronary arteries who manifest segmental early relaxation. The presence or absence of segmental early relaxation was determined angiographically in 16 patients with normal coronary arteries who underwent diagnostic cardiac catheterization because of chest pain. Seven patients had early relaxation localized to the left ventricular anterior wall and nine patients had no evidence of segmental early relaxation. Regional function was assessed from ventriculograms obtained in the right anterior oblique projection using the area method to calculate the regional fractional area of shortening. The fractional area of shortening of the anterolateral region was greater in patients with than in those without segmental early relaxation (69 +/- 4 versus 55 +/- 11%; p less than 0.01). In addition, in patients with segmental early relaxation, this variable exceeded the fractional area of shortening of the diaphragmatic region (69 +/- 4 versus 53 +/- 9%; p less than 0.01). There was no difference in the fractional area of shortening between these two regions in patients who did not manifest segmental early relaxation. These results suggest that regional differences in systolic function are present in patients with but not in those without segmental early relaxation. Augmented regional systolic function was observed in patients with segmental early relaxation and was limited to regions that manifested early relaxation.

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				I. Teplitsky, M. Wurzel, S. Artul, and M. Aygen Segmental Early Relaxation of the Left Ventricle Angiology, September 1, 1989; 40(9): 803 - 807. [Abstract] [PDF]