Clinical and hemodynamic significance of left ventricular diastolic volume changes by exercise radionuclide ventriculography in coronary artery disease

Document Type

Journal Article

Publication Date



The American Journal of Cardiology








Recent studies have suggested that left ventricular (LV) dilatation during exercise radionuclide ventriculography may identify coronary artery disease (CAD). Coronary anatomy and LV end-diastolic pressure at catheterization were compared with results of supine exercise radionuclide ventriculography in 66 patients evaluated for chest pain. Forty-six patients had significant CAD (>75% diameter stenosis) and 20 patients were normal. Radionuclide ventriculography was performed within 18 hours of catheterization, at rest and at peak exercise. Relative LV end-diastolic volumes were extrapolated from end-diastolic counts. LV end-diastolic counts increased during exercise in 19 of 20 normal subjects. In patients with CAD, LV end-diastolic counts increased in 35 (group A) and decreased in 11 (group B). The percent change in LV end-diastolic counts from rest to exercise, rest ejection fraction, exercise ejection fraction and rest LV end-diastolic pressure for each group were 20 ± 23%, 60 ± 13%, 67 ± 13% and 8 ± 3 mm Hg in normal subjects; 20 ± 20%, 50 ± 12%, 47 ± 13% and 12 ± 4 mm Hg in group A; and -9 ± 8%, 54 ± 21%, 49 ± 18% and 21 ± 7 mm Hg in group B (mean ± standard deviation). An increase in LV end-diastolic counts was unrelated to ejection fraction response or presence of underlying CAD but only correlated to rest LV end-diastolic pressure (p < 0.01). Both normal subjects and group A patients with CAD increased LV end-diastolic counts in the setting of a normal LV end-diastolic pressure, whereas group B patients with CAD and high LV end-diastolic pressure decreased LV end-diastolic counts. Thus, supine exercise-induced left ventricular dilatation is the expected response in normal subjects and patients with CAD and normal filling pressure. © 1989.