Coronary artery disease and ventricular function in angina

Coronary arteriograms and left ventriculograms of 500 patients with coronary artery disease and angina pectoris were correlated with respect to coronary arterial pattern and left ventricular dyssynergy. We found that the severity of left ventricular dyssynergy was not altered by coronary arterial pattern. The concept of dividing the left ventricle into anterior and posterior zones was validated. Patients with anterior dyssynergy alone or combined anterior and posterior dyssynergy had comparably more severe coronary artery disease in the anterior region than did patients with normal left ventriculograms or posterior dyssynergy alone. Patients with posterior dyssynergy alone or combined anterior and posterior dyssynergy had comparably more severe coronary artery disease in the posterior region than did patients with normal left ventriculograms or anterior dyssynergy alone. Lesions of greater than 90% reduction of coronary arterial luminal diameter best correlated with motion abnormalities of the left ventricular wall.