Coronary arterial and left ventriculographic findings in patients with double-vessel disease and angina pectoris.

The distribution and severity of coronary artery disease and left ventricular wall abnormalities are described in 119 patients with double-vessel disease and angina pectoris. The coronary arterial patterns were divided into right (84), mixed (17), and left (18) systems, depending upon the blood supply to the inferior surface of the left ventricle. Patterns of double-vessel disease were separated into those with 50% or greater reduction of luminal diameter involving the left anterior descending and circumflex/obtuse marginal arteries (2-LC), circumflex/obtuse marginal and right coronary arteries (2-CR), and left anterior descending and right coronary arteries (2-LR). The following relationships were noted. (1) Left anterior descending and right coronary artery disease occurs with twice the frequency of 2-LC or 2-CR disease, supporting the thesis that of the three major coronary arteries, the circumflex/obtuse marginal arteries contribute least to angina pectoris. (2) The mid portion of the left anterior descending artery is most commonly involved and the left main coronary artery least commonly involved in patients with double-vessel disease. (3) Left ventricular wall motion abnormalities are found in one-half of patients with double-vessel disease and angina pectoris with hypokinesis usually found in all areas except at the apex where dyskinesis is usually seen.