Iskandrian A S, Lichtenberg R, Segal B L, Kimbiris D, Bemis C E, Mintz G S
Cathet Cardiovasc Diagn. 1980;6(1):17-28. doi: 10.1002/ccd.1810060104.
The effects of contrast material on the left ventricular end-diastolic pressure (LVEDP) were evaluated in three groups of patients. Twenty patients (group I) with severe coronary artery disease (CAD) were found to have a change in LVEDP greater than or equal to 20 mm Hg; 15 patients (group II) with severe CAD had elevation of LVEDP less than 20 mm Hg; ten patients (group III) with normal coronary angiograms had a rise in LVEDP less than 20 mM Hg. The change in LVEDP was higher in group I than in groups II and III (P less than 0.005). Nineteen patients (95%) in group I complained of angina pectoris or had ST segment depression (or both) after ventriculography in association with the sharp increment in LVEDP. Angina or ST depression were seen in only two patients (13%) in group II and none in group III. We conclude that 1) elevation of LVEDP of 20 mm Hg or more after ventriculography may be seen in patients with severe CAD (most likely secondary to direct depressant effect of the contrast material on the myocardium) and 2) the abrupt and marked rise in LVEDP may produce myocardial ischemia due to reduction of coronary blood flow, especially to the subendocardial layer.
在三组患者中评估了造影剂对左心室舒张末期压力（LVEDP）的影响。20例严重冠状动脉疾病（CAD）患者（I组）的LVEDP变化大于或等于20 mmHg；15例严重CAD患者（II组）的LVEDP升高小于20 mmHg；10例冠状动脉造影正常的患者（III组）的LVEDP升高小于20 mmHg。I组的LVEDP变化高于II组和III组（P<0.005）。I组19例患者（95%）在心室造影后出现心绞痛或ST段压低（或两者兼有），同时LVEDP急剧升高。II组仅2例患者（13%）出现心绞痛或ST段压低，III组无此情况。我们得出结论：1）严重CAD患者在心室造影后可能出现LVEDP升高20 mmHg或更多（很可能继发于造影剂对心肌的直接抑制作用）；2）LVEDP的突然显著升高可能由于冠状动脉血流减少，尤其是心内膜下层血流减少而导致心肌缺血。
