Diastolic Time Intervals in Ischemic and Hypertensive Heart Disease: A Comparison of Isovolumic .Relaxation Time and Rapid Filling Time with Systolic Time Intervals
*
Ralph D'Angelo, M.D., Naren Shah, M.D. and Shirley Bubler, M.D.
Isovolumic relaxation time (lVRT) and npid filling time (RFf) were used to evaluate elasticity and compUance
in 11 control subjects (Group 1), in nine patients with angina (Group 2), in 11 with hypertensive heart disease (Group 3), and in ten patients with healed myocardial infarction (Group 4). Pre-ejection period (PEP), pre-ejection period index (PEPI), left ventricular ejection time (LVEn, left ventricular ejection time index (LVETI) and PEP/ L VET ntio were all derived from simultaneous recordings of phonocardiograms, ECGs, epexcardiograms, and extemal carotid arterial pulses. No patients were in congestive heart failure and none were receiving medlcadon. LVET and LVETI were the same in the control patient groups; PEP was slighdy increased in padents with healed myocardial infarctions (p However, in patients with ischemic and hypertensive heart disease, most studies have emphasized For editorial comment, see page 4
systolic events.P" The specific effects of these disorders upon diastolic events have been investigated mainly by catheterization techniques, and a significant body of knowledge pertaining to the effect of ischemia has been directed mainly to alterations in compliance. Ischemic changes, whether induced by exereise'' or pacing,'? have resulted in a "stiffness" of the myocardium which altered the filling characteristics of the ventricle and led to disproportionate increases in left ventricular end diastolic pressure with small increments in volume. Some previous investigators, using noninvasive methods, have studied compliance changes and their effect upon isovolumic relaxation and rapid filling times, and found them to be abnormal in idiopathic hypertrophic subaortic stenosis. 11,11 Few such noninvasive studies have probed the ef°From the New York Medical College Metropolitan Hospital Center, New York City. Manuscript received August 19; revision accepted October 21. Reprint requests: Dr. Shah, Metropolitan Hospital, New York, New York 10029
58 D'ANGELO, SHAH, RUILER
ent from the control group in patients with angina and hypertension (Groups 2 and 3 - p
*
Ralph D'Angelo, M.D., Naren Shah, M.D. and Shirley Bubler, M.D.
Isovolumic relaxation time (lVRT) and npid filling time (RFf) were used to evaluate elasticity and compUance
in 11 control subjects (Group 1), in nine patients with angina (Group 2), in 11 with hypertensive heart disease (Group 3), and in ten patients with healed myocardial infarction (Group 4). Pre-ejection period (PEP), pre-ejection period index (PEPI), left ventricular ejection time (LVEn, left ventricular ejection time index (LVETI) and PEP/ L VET ntio were all derived from simultaneous recordings of phonocardiograms, ECGs, epexcardiograms, and extemal carotid arterial pulses. No patients were in congestive heart failure and none were receiving medlcadon. LVET and LVETI were the same in the control patient groups; PEP was slighdy increased in padents with healed myocardial infarctions (p However, in patients with ischemic and hypertensive heart disease, most studies have emphasized For editorial comment, see page 4
systolic events.P" The specific effects of these disorders upon diastolic events have been investigated mainly by catheterization techniques, and a significant body of knowledge pertaining to the effect of ischemia has been directed mainly to alterations in compliance. Ischemic changes, whether induced by exereise'' or pacing,'? have resulted in a "stiffness" of the myocardium which altered the filling characteristics of the ventricle and led to disproportionate increases in left ventricular end diastolic pressure with small increments in volume. Some previous investigators, using noninvasive methods, have studied compliance changes and their effect upon isovolumic relaxation and rapid filling times, and found them to be abnormal in idiopathic hypertrophic subaortic stenosis. 11,11 Few such noninvasive studies have probed the ef°From the New York Medical College Metropolitan Hospital Center, New York City. Manuscript received August 19; revision accepted October 21. Reprint requests: Dr. Shah, Metropolitan Hospital, New York, New York 10029
58 D'ANGELO, SHAH, RUILER
ent from the control group in patients with angina and hypertension (Groups 2 and 3 - p
