Hemodynamics and Left Ventricular Cineangiographic Findings in Idiopathic Dilated Cardiomyopathy

The authors analyzed data from 15 patients with idiopathic dilated cardiomyopathy to evaluate the hemodynamic changes and left ventricular cineangiogram as compared with normal control. Mean right atrial pressure, right ventricular systolic pressure, mean pulmonary artery pressure and mean pulmonary wedge pressure were signigicantly elevated in patients with dilated cardiomyopathy. Left ventricular enddiastolic volume was increased in idiopathic dilated cardiomyopathy(139.9+/-58.73 ml/m2). Cardiac index, left ventricular ejection fraction and circumferential fiber shortening were significantly reduced in patients with dilated cardiomyopathy as compared with normal control(p<0.001). Hypokinetic, diffuse wall motion abnormalities of left ventricle were common in idiopathic dilated cardiomyopathy. A few cases of akinetic or dyskinetic segmental wall motion abnormalities were present. Left ventricular configurations in patients with idiopathic dilated cardiomyopathy were globe shape(53.4%) as compared with pear core shape(90%) of normal control. Associated mitral regurgitations in patients with idiopathic dilated cardiomyopathy confirmed by left ventricular cineangiogram were 53.3 percent. Mild to moderate mitral regurgitations were often present(46.6%).

Relation between Coronary Artery Cross Sectional Area and Left Ventricular Wall Mass

The coronary artery cross sectional area (CSA) is proportional to LV mass. We have measured the cross sectional area of the left and right coronary arteries in patients with ischemic heart disease to see whether it is related to the change in the LV mass. The following results were obtained ; 1) There were no significant difference in mean CSA of coronary arteries and LV mass determined by echocardiography and cineangiography between control and ischemic heart disease. 2) There were significantly increased ratio of left ventricular mass by cineangiogram to CSA of left anterior descending coronary artery in patients with myocardial infarction as compared with control group. 3) A linear relation between LV mass by cineangiogram and CSA of left coronary artery was noted in control group (r=0.53, P<0.05) and ischemic heart disease group (r=0.51, P<0.05). 4) A linear relation between LV mass determined by echocardiography and CSA of left coronary artery was noted in control group (r=0.55, P<0.05).