Left heart hemodynamics during angina pectoris induced by atrial pacing

In order to determine the associated hemodynamic events, angina pectoris was induced by an atrial pacing technic. In all patients developing angina pectoris, ischemic changes were noted electrocardiographically. The hemodynamic findings were variable: in some patients no changes were noted; in other...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1969-10, Vol.40 (4), p.483-492
Main Authors: Linhart, J W, Hildner, F J, Barold, S S, Listejw, Samet, P
Format: Article
Language:English
Subjects:
Adult
Aged
Angina Pectoris - drug therapy
Angina Pectoris - etiology
Angina Pectoris - physiopathology
Blood Pressure
Cardiac Output
Coronary Disease - etiology
Coronary Disease - physiopathology
Elasticity
Female
Femoral Artery
Heart - physiopathology
Heart Atria
Hemodynamics
Humans
Male
Middle Aged
Nitroglycerin - pharmacology
Nitroglycerin - therapeutic use
Pacemaker, Artificial
Pulmonary Artery
Sympathetic Nervous System - physiopathology
Time Factors
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Summary:In order to determine the associated hemodynamic events, angina pectoris was induced by an atrial pacing technic. In all patients developing angina pectoris, ischemic changes were noted electrocardiographically. The hemodynamic findings were variable: in some patients no changes were noted; in others, significant increases in cardiac output, left ventricular end-diastolic pressures (LVEDP), and femoral arterial and pulmonary arterial pressures occurred. These changes suggest that, initially, ischemia produces a decrease in myocardial compliance and this may also be associated with enhanced sympathetic nervous system activity. Myocardial failure may subsequently ensue, however. The administration of nitroglycerin, during angina at a fixed rapid heart rate, resulted in a reduction in LVEDP and cardiac work. Chest pain was always relieved following these hemodynamic changes, indicating a dependence upon these changes for the effectiveness of nitroglycerin.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.40.4.483