Left ventricular hypertrophy in coronary artery disease. A cardiomyopathy syndrome following myocardial infarction

Eighty-five patients with ventricular dysfunction due to coronary disease and to nonobstructive cardiomyopathy were studied by biplane angiocardiography (12/sec) to determine the extent of hypertrophy and the distinguishing features between primary myocardial and coronary disease. Patients with cardiomyopathy and equally severe dysfunction due to coronary disease had identical end-diastolic, end-systolic and stroke volume and work per square meter, stroke work per gram of ventricular mass, end-diastolic pressure, peak equatorial wall stress, ejection fraction, peak circumferential shortening velocity, peak ventricular ejection rate, peak external pump power, left ventricular mass and mass to diastolic volume ratio. Hypertrophy develops after myocardial infarction in proportion to ventricular dilatation and may result in a syndrome of massive hypertrophy, hypokinesis and congestive failure quantitatively identical to that found in primary cardiomyopathy except for etiology. Hypertrophy is associated with normalization of wall stress in both coronary and primary myocardial disease and is thus not dependent on the type of insult to the contractile mechanism.