Analysis of Left Ventricular Pressure During Isovolumic Relaxation in Coronary Artery Disease

When a decrease in left ventricular isovolumic pressure is considered as an exponential, the rate of relaxation can be defined by a time constant (T). Previously, T has been calculated from the slope of In (pressure) against time, but this method is valid only when the asymptote of the exponential is zero. In this study two estimates of T were made: Tin from the slope of In (pressure) against time, and TEXP by a method of exponential analysis that also estimated the asymptote. These techniques were applied to measurements of left ventricular pressure made at increasing pacing rates in three groups of patients catheterized for chest pain: group 1 (n = 9) - normal coronary arteriograms; group 2 (n = 9) - coronary artery disease (CAD) but no angina or lactate production during pacing; and group 3 (n = 9) - CAD and angina during pacing. Tjn was always shorter than TEXP, and in groups 1 and 2 TEXP was dependent on heart rate, whereas Tin was not. The asymptote was negative, and increased toward zero during pacing in groups 1 and 2. The difference between TEXP and Tin could be related to the value of the asymptote. In 18 of 20 beats tested, pressures calculated from TEXP and the asymptote were in closer agreement with measured pressures than were the pressures predicted by Tin. Despite their different values, TEXP and Tin each distinguished between the three groups. Although the choice of an exponential model is arbitrary, isovolumic pressure decrease approximates to a single expontial; but this study suggests that both T and the asymptote are variable.