Reversibility of left ventricular asynergy by nitroglycerin in coronary artery disease

To evaluate the potential reversibility of left ventricular asynergy in patients with coronary artery disease, pre- and postnitroglycerin left ventriculography was performed in 32 subjects. In four other subjects left ventriculography was repeated without intervention of nitroglycerin. Changes in ejection fraction and percentage of systolic shortening of three minor axes from the first to the second angiogram were then calculated. Changes were not significant for the myocardial infarction group or for the control group without the intervention of nitroglycerin. Normal left ventricles showed small but significant changes (p < 0.05). Patients with coronary artery disease but without previous myocardial infarction who demonstrated asynergy in their first angiogram showed three types of response: (1) no significant change (p > 0.05)-irreversible asynergy; (2) significant change (p < 0.025) with residual dysfunction-partially reversible asynergy; (3) significant change (p < 0.001) without residual dysfunction-completely reversible asynergy. It is concluded that postnitroglycerin ventriculography is useful in assessing the reversibility of left ventricular asynergy in patients with coronary artery disease.