Cardiac Performance After Diagnostic Coronary Arteriography

Abstract

Cardiac performance was assessed before and after diagnostic coronary arteriography in 19 patients with heart disease. There was no significant change in cardiac output, heart rate, stroke volume, hemoglobin, hematocrit, and mean systemic arterial pressure. Left ventricular (LV) filling pressure and mean pulmonary artery pressure increased temporarily. The increased left ventricular filling pressure was accompanied by an increase of LV work performed in a few patients; in the remainder the left ventricle performed less work. In four dogs, selective left coronary arteriography resulting in increased ventricular filling pressure, was accompanied by an increase of left ventricular end-diastolic (V ED ) and stroke volumes; the ejection fraction and heart rate remained unchanged. If the animal studies (increased V ED accompanying increased ventricular filling pressure) can be applied to patients with heart disease, the alteration of left ventricular function can be considered on the basis of the Frank-Starling mechanism. To cope with the temporary depression of its function, the left ventricle of patients with heart disease utilized the Frank-Starling mechanism resulting in an adequate (essentially unchanged) cardiac output from an increased left ventricular filling pressure. The normal left ventricle of the dog, stressed more than is appropriate clinically, shows an increased stroke volume accompanying the increased end-diastolic volume.