Effects of Digitalis on Normal and Abnormal Left Ventricular Segmental Dynamics
JAY H. KLEIMAN, MD EDWIN L. ALDERMAN, MD, ROBERT H. GOLDMAN, MD, NEIL 6. INGELS, PhD GEORGE T. DAUGHTERS II, EDWARD 6. STINSON, MD,
FACC FACC MS FACC
with the technical assistance of ANNE SCHWARZKOPF CATHERINE KUSNICK CAROL MEAD Stanford, California
From the Division of Cardiology and the Department of Cardiovascular Surgery, Stanford University School of Medicine, Stanford, California and the Palo Alto Medical Research Foundation, Palo Alto, California. This work was supported in part by Grant HL-5888 and Grant HL-17993 from the National lnstltutes of Health, Bethesda, Maryland. Dr. Goldman was supported in part by an Established lnvestlgatorshlpfrom the American Heart Association. Manuscript received August 9, 1978; revised manuscript received Dxember 12, 1978, accepted December 28,1978. Address for reprints: Edwin L. Alderman, MD, Cardiology Division, Stanford University School of Medicine, Stanford, California 94305.
To study the effects of digoxin on regional left ventricular performance, continuous ventricular dynamics were assessed in nine patients with stable coronary disease. Computer-as&ted analysis of the fluoroscopic motion of surgically implanted mid wall myocardial markers was used. The markers define six minor ventricular radll and outflne the left ventrkte. One and one-half hours after admfnktratlon of 1 mg of Intravenous dfgoxin, mean velocity of circumferential fiber shortenlng for all segments increased 19 percent, from 0.67 f 0.06 to 0.78 f 0.06 ciccumferencekrec (P CO.01) and ejection fraction Increased 4.5 percent, from 0.50 f 0.03 to 0.53 f 0.03 (P 80 % Stenosis RCA, LAD LAD RCA, LAD LAD LAD, LCx LCx, RCA RCA, LAD LAD LAD
Postoperative Marker Analysis: Location of Segments With Abnormal Baseline Dynamics Early Total Shortening* Shortening+ (