Relationship between regional ventricular asynergy and the anatomic lesion in coronary artery disease

The percentage of left ventricular (LV) asynergy was measured in patients with isolated narrowing or obstruction of the right coronary artery (RCA), the anterior descending branch of the left coronary artery (LAD), or a combination of these lesions.Incomplete obstruction of a vessel was not associated with important asynergy. Isolated obstruction of the LAD caused asynergy of the distal two-thirds of the anterior wall and apex of the LV and 46 per cent asynergy. Isolated obstruction of the RCA caused asynergy of the middle or basal thirds of the diaphragmatic surface and 15 per cent asynergy. Double-vessel disease produced a combination of the individual lesions, and total obstruction of both arteries caused extensive asynergy.In each patient the extent of asynergy was modified by the underlying coronary artery anatomy and the collateral circulation. Ejection fraction was related to the percentage of LV asynergy.