Myocardial lactic acid balance after left ventriculography.

In order to study the effects of contrast media on myocardial metabolism the percentage of lactic acid extraction during left ventricular angiography has been determined in 16 normal patients (Group I), and in 29 patients with coronary artery disease (Group II). In addition, the lactic acid uptake was evaluated after atrial pacing (in 10 patients of Group I and in 13 patients of Group II) and after aortography (in 6 patients of Group I and in 9 patients of Group II). Normal patients usually did not show a myocardial lactic acid production after left ventriculography while the patients with coronary artery disease showed a net lactic acid production in the coronary sinus, which was similar to that obtained after atrial pacing stimulation and after aortography. These results indicate that ventriculography can be a useful technique to assess the kinetics of lactic acid uptake or release into the coronary sinus in patients with coronary artery disease and, in this respect could be useful for studying myocardial metabolism in aortic valve disease and to assess the toxicity of different contrast media.