Effects of the Mueller maneuver on global and regional left ventricular function in angina pectoris with or without previous myocardial infarction |
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| Authors: | S M Scharf B O Woods R Brown A Parisi M M Miller D E Tow |
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| Affiliation: | 1. Department of Critial Care Medicine, The First Affiliated Hosptial of Gannan Medical University, Ganzhou of Jiangxi, China;2. Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China;3. Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China;4. Department of Pediatric Ophthalmology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China;1. Department 2 of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France;2. Aix-Marseille University, Marseille, France;3. Department of Urology & Renal Transplantation, La Conception University Hospital, Assistance Publique -Hôpitaux de Marseille, Marseille, France;4. Department of Oncology, Antoine-Lacassagne Center, Nice, France;5. Service d''Oncologie Médicale, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France;6. Centre Saint Louis; Pierre Guillet, Hôpital Font-Pré, Toulon, France;7. Service d''urologie, d''andrologie et de transplantation rénale, Université de Nice-Sophia-Antipolis, Hôpital Pasteur 2, Centre hospitalier universitaire de Nice, Nice, France;8. Laboratoire de génétique des tumeurs solides—Institute for Research on Cancer and Aging of Nice (IRCAN)—INSERM U1081—CNRS UMR 7284—Université de Nice-Sophia-Antipolis, Nice, France;9. Department of Surgical Urology, North Hospital, Assistance-Publique-Marseille, Marseille, France;10. Service d''Urologie, Hôpital Sainte Musse, Toulon, France;11. Nuclear Medicine Department, A. Lacassagne Cancer Center, Nice, France;12. Nuclear Medicine Department, North Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France;13. Centre Azuréen de Cancérologie, Mougins, France;14. Service de Radiothérapie, Ramsay Générale de Santé, Hôpital Privé Clairval, Marseille, France;15. Nuclear Medicine Department, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France |
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| Abstract: | ![]()
In patients with coronary artery disease, left ventricular (LV) regional wall akinesia can develop during the Mueller maneuver. The present study determines if the presence of myocardial ischemic disease with no infarction is a sufficient condition for this to occur, or if the presence of prior acute myocardial infarction (MI) is necessary. In men, first-pass radionuclide ventriculography was performed in the 30 degree left anterior oblique supine position to measure LV ejection fraction, end-diastolic and end-systolic volumes and heart rate, and to obtain an image of the LV cavitary perimeter. This procedure was performed in 4 subject groups: 13 normal volunteers, 25 patients with coronary artery disease but no prior MI, 13 patients with coronary artery disease and prior nontransmural MI, and 36 patients with coronary artery disease and prior transmural MI. All patients had angina and underwent routine contrast coronary angiography; 60 also underwent contrast coronary angiography; 60 also underwent contrast LV angiography. Ejection fraction decreased during the Mueller maneuver in each of all the coronary artery disease groups (p less than 0.01), but not in the normal subjects. Heart rate increased in groups 1, 2 and 4 (p less than 0.01), and end-diastolic volume decreased in all 4 groups (p less than 0.01), whereas end-systolic volume did not change. Only in group 4 did regional wall akinesia develop (17 patients) during the Mueller maneuver. Among patients who had akinesia during the Mueller maneuver and also underwent routine contrast ventriculography, half of the akinetic segments were not seen on routine contrast study, but were seen only on radionuclide ventriculography during the Mueller maneuver.(ABSTRACT TRUNCATED AT 250 WORDS) |
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