Trevi G P, Marini A, Benussi P, Caobelli A, Olivari Z, Sheiban I, Frasson F
G Ital Cardiol. 1976;6(2):214-9.
Two successive left ventriculargraphs [in basal conditions and after Nitroglycerin (TNG)] were performed with the same technical procedures in 20 patients before coronary arteriography. End-diastolic and end-systolic volumes and ejection fraction were studied following Greene's modified method. Diastolic and systolic ventricular projected images were divided into four zones and their variations were evaluated after TNG. Two patients did not show any significant abnormality (pseudoangor); two others suffered from cardiomyopathy (myocardosis) with mitral regurgitation and no coronary artery disease; two had restrictive cardiomyopathy. Fourteen had a coronary artery disease: seven of them had signs of end-systolic mitral regurgitation. End-diastolic and end-systolic volumes decreased and ejection fraction increased after TNG in all of these cases except in the two suffering from cardiomyopathy (ESV increased and EF decreased). Mitral regurgitation disappeared in all of them. In patients with coronary artery disease and mitral regurgitation the volume variations were slighter, and the increase of EF was larger than in the other cases. Finally, a decrease in asynergic and hypokinetc zones was observed, whereas no variations were seen in diskinetic zones. TNG can improve left ventricular kinetics by decreasing the pre-load, the after-load and myocardial oxygen consumption. Demonstration of this improvement could be of prognostic value.
在20例患者进行冠状动脉造影术前，采用相同技术程序进行了两次连续的左心室造影（基础状态下和舌下含服硝酸甘油后）。按照格林改良法研究舒张末期和收缩末期容积以及射血分数。舒张期和收缩期心室投影图像被分为四个区域，并在舌下含服硝酸甘油后评估其变化。两名患者未显示任何明显异常（假性心绞痛）；另外两名患有心肌病（心肌症）伴二尖瓣反流且无冠状动脉疾病；两名患有限制性心肌病。14名患有冠状动脉疾病：其中7名有收缩末期二尖瓣反流体征。除两名患有心肌病的患者（收缩末期容积增加而射血分数降低）外，所有这些病例在舌下含服硝酸甘油后舒张末期和收缩末期容积均减小，射血分数增加。二尖瓣反流在所有患者中均消失。在患有冠状动脉疾病和二尖瓣反流的患者中，容积变化较小，射血分数的增加大于其他病例。最后，观察到运动不协调和运动减弱区域减少，而运动障碍区域未见变化。舌下含服硝酸甘油可通过降低前负荷、后负荷和心肌耗氧量来改善左心室动力学。证明这种改善可能具有预后价值。
