Cardiomyopathic syndrome due to coronary artery disease. I: Relation to angiographic extent of coronary disease and to remote myocardial infarction.

The relation between the extent of angiographic coronary artery disease and the presence of chronic heart failure in patients with coronary artery disease has not hitherto been clearly elucidated. In the present study clinical, ventriculographic, and coronary arteriographic features are compared in 84 patients with coronary artery disease. The extent of coronary disease is measured by the angiographic jeopardy score, which expresses how many of six coronary arterial segments are jeopardised by significant ( > 70 % estimated luminal area reduction) proximal stenoses. Each jeopardised segment is counted as 2 points. Thirty of the 84 patients had clinical evidence of chronic heart failure, all of whom were classified as having a cardiomyopathic syndrome caused by coronary artery disease since all had significant reduction of the left ventricular ejection fraction (<0-48) because of multiple and widespread left ventricular wall motion abnormalities. There were no patients in this study with chronic heartfailure from other causes (e.g. isolated ventricular aneurysm). The mean jeopardy score in the patients cardiomyopathy was higher than in the patients without cardiomyopathy and all patients with cardiomyopathy had a jeopardy Distal coronary disease unrelated to the presence or absence of cardiomyopathy (0.5± 2 vs 0 4 ± 0 2 diseased distal vessels Cardiomyopathy strongly the occurrence of multiple myocardial infarcts (1.9±0.3 myocardial infarcts per patient) in the group with cardiomyopathy 0-9±0-2 myocardial infarcts patient

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