To assess whether changes in left ventricular filling which are known to occur during myocardial ischaemia can be detected using transmitral Doppler ultrasound,8 patients with coronary artery disease who were to undergo percutaneous transluminal coronary angioplasty were studied. Doppler indices of left ventricular filling were recorded before, during and after 16 balloon inflations. All patients developed chest pain and electrocardiographic changes of myocardial ischaemia during balloon inflation. Mean pulmonary wedge pressure increased whereas no difference in heart rate was observed for the total study group. During balloon inflation, a significant decrease in peak early filling velocity, the E/A ratio and the ratio of the early to atrial flow velocity integral were documented. The peak atrial filling velocity was found to increase significantly during balloon inflation. The results of this study demonstrate that changes in left ventricular filling during myocardial ischaemia caused by acute coronary occlusion can be detected by transmitral Doppler ultrasound. Furthermore,they appear to reflect the known haemodynamic changes that occur during myocardial ischaemia.

Keywords:
Doppler ultrasound, Myocardial ischaemia, Coronary angioplasty
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1992
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