Dynamic ventriculography with K-strophantin.

Dynamic ventriculography, before and after K-strophantin, was performed in 14 patients with coronary artery disease. Qualitative and quantitative evaluation of hemodynamic and angiographic data has been assessed. Digitalis was found to have different action on asynergic areas--that is improvement in some areas and worsening in others--and little or no action on normokynetic areas. After administration of K-strophantin (0.008 mg/kg), 54% of the examined asynergic zones improved their segmental systolic shortening while 34% worsened or appeared diskynetic. Improvement of asynergic zones could be related to the presence of viable myocardium, while paradoxical systolic motion would suggest the presence of frank fibrosis. Therefore 2 different behaviors of global ventricular function were observed in CAD patients. When ventricular function improves, the values of ejection fraction at midejection show that the improvement is obtained mostly in the first half of ejection. Since heart rate was fixed, enddiastolic volume unchanged and left ventricular systolic pressure increased, it seems likely that the observed changes could be due to a direct inotropic effect of K-strophantin. The author's opinion is that 'strophantin test' could be useful to test whether ventricular function would be enhanced using maintenance digitalis therapy in CAD patients and to determine residual contractile reserve; in addition potential worsening of ejection fraction can be elicited and then a more complete pattern of ventricular function can be provided.