The effects of abrupt coronary occlusion on left ventricular ejection were studied during percutaneous transluminal coronary angioplasty. Measurements of blood velocities in the ascending aorta were used to determine peak acceleration, peak velocity, and stroke integral of left ventricular ejection during and immediately after balloon occlusion at 31 intracoronary sites in 25 patients. Compared to preinflation values, small but statistically significant(P < 0 .05) decreases occurred for peak acceleration (16.3 ± 1.3 to 15.0 ± 1.4 m/s/s), peak velocity (63 ± 4.7 to 58 ±4.3 cm/s), and stroke integral (10.0 ± 0.7 to 9.0 ± 0.7 cm; mean ± SE). All three ejection indices returned to preinflation values immediately after balloon deflation. When subgrouped according to proximal (n = 16 sites in 16 patients) and nonproximal occlusion (n = 15 sites in 9 patients), significant (p < 0.01) decreases occurred for peak acceleration (18.2 ± 1.4 to 15.8 ± 1.5 m/s/s), peak velocity (69 ± 4.3 to 59 ± 4.0 cm/s), and stroke integral (10.2 ±0.7 to 8.8 ± 0.6 cm) only after proximal occlusion. Reperfusion after proximal occlusion resulted in a small but significant (p < 0.05) increase in peak acceleration (18.2 ± 1.4 to 19.6 ± 1.5 m/s/s) relative to preinflation values. This study demonstrates that ischemia resulting from abrupt coronary occlusion in humans can result in rapid decreases in maximum acceleration and velocity of ascending aortic blood flow which are rapidly reversible with reperfusion. Accordingly, these indices may be useful for noninvasi ve assessments of the functional significance of transient episodes of myocardial ischemia.

Keywords:
Ventricular performance, Coronary artery disease, Doppler ultrasound, Percutaneous transluminal coronary angioplasty
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1989
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