EFFECTS OF ALTERATIONS IN SYSTOLIC PRESSURE ON RADIONUCLIDE MEASUREMENTS OF LEFT-VENTRICULAR FILLING DYNAMICS

To determine the effects of steady-state left ventricular systolic pressure alterations on radionuclide measures of left ventricular filling dynamics, we studied 15 normal patients and 17 patients with nonischemic heart disease. Micromanometer left ventricular pressures and computer assisted forward gated radionuclide angiograms were acquired simultaneously. Right atrial pacing maintained heart rates constant during the baseline condition and methoxamine and nitroprusside infusions. Diastolic filling dynamics, peak filling rate and time to peak filling rate were calculated using a three harmonic Fourier analysis of the left ventricular time-activity curves. Left ventricular systolic pressure increased to 165 +/-25 mmHg with methoxamine (p < 0.001) and decreased to 106 +/- 18 mmHg with nitroprusside (p < 0.001) from a baseline value of 133 +/- 16 mmHg. Radionuclide left ventricular filling dynamics did not change significantly. Thus, we conclude that radionuclide measurements of left ventricular filling dynamics are not affected by modest, steady-state alterations in left ventricular systolic pressure and can therefore be useful for the assessment of left ventricular diastolic function during interventions which may also affect left ventricular systolic pressure.