| Abstract: | AIM: To study association between the state of the left ventricle (LV) of the heart, characteristics of a 24-h profile of arterial pressure (AP) and episodes of painless myocardial ischemia (PMI). MATERIAL AND METHODS: Echocardiography, bifurcation 24-h monitoring of AP and ECG were conducted in 137 patients with effort angina (EA) receiving clinically effective antianginal therapy. RESULTS: Episodes of PMI at daytime were detected in 33 (24.1%) patients, at day and nighttime in 10 (7.3%) patients. There were significant differences neither by LV state nor by 24-h AP profile in patients free of PMI and those with daytime episodes. Patients with day and night PMI episodes had dilated LV and a decreased fall of night AP. Comparison of the parameters of 24-h AP and ECG monitoring has demonstrated that PMI episodes follow a rise in systolic and diastolic AP. In ischemia systolic and diastolic AP rise. In postischemic period systolic AP lowered while diastolic AP rose higher. CONCLUSION: Changes in diastolic AP may contribute to both onset and arrest of PMI. Decreased night fall in AP is one of the mechanisms compensating impaired coronary circulation. |
