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Resting Early Peak Diastolic Filling Rate: A Sensitive Index of Myocardial Dysfunction in Patients with Coronary Artery Disease

West Roxbury Veterans Administration Medical Center, West Roxbury
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts

Correspondence: For reprints contact: Andrew J. Kemper, MD, Veterans Administration Medical Center, West Roxbury, MA 02132.

ABSTRACT

Resting first-pass radionuclide angiocardiography (RNA) was used to derive left-ventricular (LV) peak diastolic filling rates (PFR) in normals (Group 1: N = 12) and in patients with coronary artery disease (CAD), both without (Group 2: N = 27) and with previous myocardial infarction (Group 3: N = 23). Resting peak filling rates were significantly depressed in both Group 2 (1.61 ± 0.36; p < 0.01) and Group 3 (1.35 ± 0.26; p < 0.001) patients when compared with Group 1, normals (2.14 ± 0.63). Even though LV systolic function of Group 2 patients was normal and comparable to that in Group 1 (EF = 0.55 ± 0.06 against EF = 0.55 ± 0.06 NS), diastolic dysfunction [PFR < 1.61 end diastolic volume/sec (EDV/sec)] was present at rest in 14 of 27 (52%). Depressed PFR values were also seen in 20 of 23 Group 3 patients (87%). It appears that (a) resting PFR is a sensitive and easily obtainable parameter of the diastolic dysfunction associated with CAD; (b) abnormal PFR values are seen in almost all patients with previous myocardial damage, and (c) a significant proportion of CAD patients without any evidence of abnormal systolic function have depressed resting PFR of the LV.

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