Relationships between coronary artery obstruction, asynergy, presence of collaterals and the ejection fraction of the left ventricle in patients with coronary heart disease.

Abstract

Cardioangiographic scores of coronary artery obstructions and corresponding myocardial involvement (MCOS), presence of collaterals (CollS), and asynergy of the left ventricular wall (LVMS) as well as the left ventricular ejection fraction (EF) were examined in 67 patients with coronary heart disease. A covariation was found between LVMS, EF, ECG changes, and a history indicating a previous myocardial infarction (MI). In a multiple regression analysis the EF covariated with LVMS but not with MCOS and CollS. LVMS indicated a previous MI with at least the same sensitivity and specificity as EF. MCOS and CollS give additional information. Collaterals as well as a high MCOS in relation to the LVMS indicate obstruction of coronary arteries which subserve 'non-fibrotic' myocardium. A patient with a high MCOS and CollS and a low LVMS should be expected to gain most functional improvement from coronary bypass surgery. The scores MCOS, CollS and LVMS are comparatively easy to determine and give a more diversified picture of the state of the myocardium than the EF alone.