Restoration of Regional Wall Motion by Nitroglycerin Therapy in Patients with Left Ventricular Asynergy

¹ McGill University Clinic, Division of Cardiology, Royal Victoria Hospital, Montreal, Canada

Abnormalities in regional wall motion are not uniformly improved following aortocoronary bypass operation. This study demonstrates that regional wall motion abnormalities may be reversed with nitroglycerin therapy. Eighteen asynergic regions in seven patients with coronary artery disease were studied before and after sublingually administered nitroglycerin. Although none of the normal areas became abnormal after nitroglycerin therapy, there were marked changes in the asynergic regions. Of the seven hypokinetic areas, three became normal. Of the 11 dyskinetic areas, 4 showed a normal reduction in area after nitroglycerin treatment. The study illustrates that because areas of regional dysfunction may not exist as fixed lesions, their recoverability can be realized by changing the loading conditions of the ventricle. Identification of such potentially viable areas of asynergy may prove helpful in the selection of cases for aortocoronary bypass operation.

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