Linksventrikuläre Funktion während symptomatischer und asymptomatischer Myokardischämie

Zusammenfassung

Um zu untersuchen, ob sich Episoden stummer und symptomatischer Myokardischämie während transluminaler koronarer Angioplastie (PTCA) im Ausmaß der linksventrikulären (LV) Funktionsbeeinträchtigung unterscheiden, wurden Auswurffraktion (EF), Indices des endsystolischen und enddiastolischen Volumens (ESV EDV) sowie maximale Auswurf- (PER) und maximale Füllungsgeschwindigkeiten (PFR) vor und während PTCA kontinuierlich on-line mit einer nicht-bildgebenden Csl-Szintillationssonde bestimmt. 13 Patienten (Alter 54 ± 7,4 Jahre) waren symptomatisch, 10 Patienten (Alter 61 ±8 Jahre) waren asymptomatisch. Die linksventrikulären Funktionsparameter zeigten keine signifikanten Unterschiede zwischen den beiden Patientengruppen. Es wird daher gefolgert, daß symptomatische und stumme Ischämieepisoden während PTCA zu einer gleichartigen Beeinträchtigung der systolischen und diastolischen LV-Funktion führen. Somit kann während PTCA aufgrund der klinischen Symptomatik nicht auf das Ausmaß der LV-Funktionsstörung geschlossen werden.

Summary

Transluminal coronary angioplasty (PTCA) causes transient occlusion of the coronary artery and temporary ischemia of the left ventricle. Left ventricular dysfunction during silent and symptomatic episodes of myocardial ischemia during PTCA was evaluated continuously with a newly developed miniature, non-imaging scintillation probe. Parameters of left ventricular function were compared before and during balloon inflations of 60s duration: ejection fraction (EF), indices of end-systolic and end-diastolic volumes (ESV EDV), peak ejection and peak filling rates (PER, PFR). 13 patients (age 54 ± 7.4 years) were symptomatic, 10 patients (age 61 ± 8 years) were asymptomatic. Impairment of left ventricular function during ischemia did not show any significant differences between the symptomatic and asymptomatic patients. It is therefore concluded that symptomatic and asymptomatic episodes of myocardial ischemia during PTCA cause similar impairment of systolic and diastolic left ventricular function. The degree of left ventricular dysfunction during PTCA cannot be estimated on the basis of clinical symptoms.

Schlüsselwörter

Stumme Ischämie - LV-Funktion - PTCA - Radionuklidventrikulographie

Key words

Silent ischemia - PTCA - radionuclide ventriculography - left ventricular function

Herrn Prof. Dr. Kaltenbach zum 65. Geburtstag

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