[Assessment of left ventricular function at rest and during exercise by gated cardiac blood pool scan and pressure measurement of the pulmonary artery by Swan-Ganz catheter].

Gated cardiac blood pool scan and hemodynamic parameters by Swan-Ganz catheter were simultaneously measured in five normal subjects (Group A), five patients with coronary artery disease (CAD) without angina on exercise (Group B) and nine patients with CAD with angina on exercise (Group C) in order to evaluate left ventricular function at rest and during supine bicycle ergometer exercise. Work load was gradually increased every 3 minutes and each data were acquired using a digital computer. There was a fairly good correlation (r = 0.83) between stroke volume by thermodilution method and stroke counts corrected by counts/ml of blood on gated cardiac blood pool scan, which were obtained by subtraction of end-systolic counts (ESC) from end-diastolic counts (EDC) in the region of interest arranged at the left ventricle. Stroke counts obtained by this method are considered to reflect a change in the left ventricular volume during exercise. As to the correlation between pulmonary capillary wedge pressure (PCWP) and stroke work index (SWI) at peak exercise, there was a large increase in SWI (78.9 +/- 17.6 to 112.3 +/- 30.0 g X m/m2) with a small rise in PCWP (10.0 +/- 1.9 to 16.2 +/- 4.0 mmHg) in Group A. In Group B, SWI was increased (57.8 +/- 15.8 to 92.9 +/- 25.2 g X m/m2) with a moderate rise in PCWP (11.8 +/- 3.7 to 20.0 +/- 3.1 mmHg) at peak exercise. In Group C, there was a trivial increase in SWI (74.0 +/- 16.0 to 81.2 +/- 29.3 g X m/m2) despite a marked rise in PCWP (13.1 +/- 3.1 to 33.4 +/- 8.9 mmHg). Similar relationship was present between SWI and EDC. On mild exercise of 25w, however, the rise in PCWP was more prominent rather than the increase in EDC in Group C. This indicates that the left ventricle in Group C is operating on a very steep portion of the diastolic pressure-volume curve.