Spontaneous changes in left ventricular function between sequential studies

To evaluate day to day changes in left ventricular function, studies were performed in 17 patients in stable condition undergoing elective cardiac catheterizatlon and coronary arteriography on successive days. Seven patients had significant coronary artery disease, seven had significant valvular heart disease, two had both lesions, and one had no demonstrable heart disease. The group as a whole demonstrated no significant day to day changes in any measured parameter of left ventricular function .... The hematocrit decreased from 43.4 ± 4.3 to 41.5 ± 4.5 percent (P < 0.01). Individual patients showed rather marked day to day variation. The mean (± standard deviation) percent changes for paired determinations in individual patients were: mean arterial pressure - 1.0 ± 19.4 percent; heart rate 3.4 ± 14.6 percent; cardiac index - 1.2 + 19.4 percent; left ventricular end-diastolic pressure -2 ± 37.2 percent; left ventricular stroke work index -10.7 ± 34.6 percent; end-diastolic volume -0.9 ± 23.1 percent; ejection fraction -6.2 ± 15.7 percent; mean circumferential fiber shortening rate -7.7 ± 24.8 percent. Left ventricular wall motion abnormalities present in five patients were unchanged in site. The extent of asynergy changed by an average of 2 percent (range -2 to +4 percent). The range of these day to day changes in the parameters of left ventricular function without therapeutic intervention must be considered when evaluating the effects of therapy. Since wall motion abnormalities were constant in site and showed little variation in extent, the effects of medical and surgical treatment on left ventricular asynergy can be assessed by sequential studies.