ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
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Factors Affecting Regional Myocardial Function in Patients with Chronic Critical Coronary Artery Stenosis or Occlusion [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2000; 28(5): 282-288

Factors Affecting Regional Myocardial Function in Patients with Chronic Critical Coronary Artery Stenosis or Occlusion

A. Aziz KARADEDE1, Y.M.Sıddık ÜLGEN1, Murat SUCU1, Sait ALAN1, Nizamettin TOPRAK1

Although the effects of collateral and antegrade flow on regional functions after acute myocardial infaretion have been intensively investigated, the effects of these and some other factors on regional myocardial functions in patients with chronic coronary artery lesions have not been adequately interrogated yet and results remains rather controversial. In our study, we have investigated effects of collateral and antegrade flow and degree and location of stenosis (proximal or middle) on regional myocardial functions in patients with chronic left anterior descending (LAD) artery stenosis. For this purpose 121 patients whose coronary angiography and ventriculography were performed in our catheterization laboratory were divided into three groups. Group A, control group (n= 14) was consisted of patients with normal angiographic and ventriculographic evaluation. Group B had patients with critical narrowing >%75 in LAD (n=65) and group C had patients with total occlusion in LAD (n=42). Regional wall motion was expressed as the fractional changes from end-systolic to enddiastolic hemiaxial length. The territory of LAD was divided into four segments as anterobasal, mid anterior anteroapical and apex. Regional function of all segments in group C were very low compared to group A and B. In group B, there was a significant effect of TIMI antegrade flow to each regional function. Moreover, a subgroup analysis considering LAD stenosis between %75-90 and >%90 demonstrated a better mid anterior and anteroapical function in the former. Location of the lesion and collateral flow in group B and antergrade flow in group C had no relation with regional function , but collateral flow in group C had significant relation. Patients with TIMI 3 flow had better left ventricular functions in all segments compared to TIMI 1 and 2 patients whereas, no significant difference was demonstrated between TIMI 1 and 2 patients. Furthermore, in this group, anterobasal function in proximal LAD lesions were worse tendeney than those in the middle. Conclusively, antegrade flow and severity of stenosis have effective on regional function (especially in mid anterior and anteroapical) in patients with critical LAD stenosis whereas, the degree of collateral flow and location of the lesion have a significant effect on regional function in patients with total LAD occlusion (especially in anterobasal region).

Keywords: Left anterior descending artery, regional function, collateral flow, antegrade flow

How to cite this article
A. Aziz KARADEDE, Y.M.Sıddık ÜLGEN, Murat SUCU, Sait ALAN, Nizamettin TOPRAK. Factors Affecting Regional Myocardial Function in Patients with Chronic Critical Coronary Artery Stenosis or Occlusion. Turk Kardiyol Dern Ars. 2000; 28(5): 282-288
Manuscript Language: Turkish


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