Clinical Study
Impaired left ventricular relaxation during pacing-induced ischemia*

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Rapid atrial pacing was performed in 15 patients at the time of cardiac catheterization. The results indicate that tachycardia may produce incomplete left ventricular relaxation in patients with disorders characterized by ischemia, but not in those with a normal left ventricle. This phenomenon was characterized by (1) a decrease in the peak negative value for first derivative of left ventricular pressure (dP/dt), which was used in the study as an index of left ventricular relaxation rate, (2) an increase in left ventricular diastolic pressure, and (3) a decrease in left ventricular internal diameter. These findings suggest that ventricular relaxation is an important determinant of left ventricular diastolic pressure-volume relations and that an impairment of ventricular relaxation may be partly responsible for the apparent decrease in left ventricular diastolic compliance observed during pacing-induced angina pectoris.

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    *

    This study was supported by North Carolina Heart Association Grant 1971-72-A-7 and National Institute of Health Grants HL 14,883-01 and HL 05727-06.

    *

    Recipient of Special Research Fellowship 1-F03-HL-55243-01 from the National Heart and Lung Institute.

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