Left ventricular contractility related to the state of the coronary bed.

The authors studied total and segmental contractility of the left ventricular (LV) myocardium in patients with acute myocardial infarction with single and multiple coronary artery (CA) disease. The group included 75 patients with acute transmural myocardial infarction; coronary arteriography was performed in 56 of them. All patients underwent echocardiography (sector scanning), on the basis of which total (ejection fraction) and segmental parameters (segmental ejection fraction, fraction of segmental wall shortening, velocity of change of segmental area, velocity of change in segmental wall thickness) of LV contractility were calculated. Patients with single CA affection display only a moderate decrease in total ejection fraction, and an insignificant number of complications of myocardial infarction. Segmental contractility data showed severe hyperkinesis of the intact segments of the left ventricle. Multiple CA disease is associated with a marked decrease in both total and segmental contractility of the LV myocardium, and there is no hyperkinesis of the intact segments of the heart.