Echocardiographic left ventricular size and closure time of the mitral valve were measured in 204 consecutive patients having cardiac catheterization and significant coronary artery disease to determine if these measurements could assess the extent of left ventricular dysfunction and predict surgical mortality for those patients treated surgically. Among 30 patients having both an echocardiographically increased left ventricular internal dimension at the end of diastole and a prolonged time of mitral valve closure, left ventriculographic studies showed greater than 40 percent abnormality of wall motion in 24 patients (80 percent), and the resting left ventricular end-diastolic pressure averaged 23 mm Hg. Of the remaining 174 patients, only 13 (7 percent) had greater than 40 percent abnormality of wall motion, and the left ventricular end-diastolic pressure averaged 11 mm Hg. Eighty-six of the 204 patients received surgical therapy. Mortality during hospitalization for those surgical patients with both echocardiographic findings was 67 percent (6/9) compared to 1 percent (1/77) for those without both findings (P<0.001). The combination of an echocardiographically increased left ventricular diastolic dimension together with a prolonged mitral valve closure (1) correlates with extensive abnormalities of wall motion and elevated left ventricular end-diastolic pressure at cardiac catheterization, and (2) is associated with an increased surgical risk.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine