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Prolonged postischemic regional left ventricular delayed relaxation or diastolic asynchrony detected by color kinesis following coronary vasospasm

      Coronary vasospasm is characterized by transient myocardial ischemia resulting from temporary coronary flow obstruction followed by reperfusion.
      • Maseri A.
      Role of coronary artery spasm in symptomatic and silent myocardial ischemia.
      ,
      • Yasue H.
      • Omote S.
      • Takizawa A.
      • Nagao M.
      Coronary arterial spasm in ischemic heart disease and its pathogenesis. A review.
      Several studies have suggested that left ventricular (LV) diastolic function may be a more sensitive marker of coronary ischemia than systolic function.
      • Bonow R.O.
      • Kent K.M.
      • Rosing D.R.
      • Lipson L.C.
      • Bacharach S.L.
      • Green M.V.
      • Epstein S.E.
      Improved left ventricular diastolic filling in patients with coronary artery disease after percutaneous transluminal coronary angioplasty.
      ,
      • Carroll J.D.
      • Hess O.M.
      • Hirzel H.O.
      • Turina M.
      • Krayenbuehl H.P.
      Left ventricular systolic and diastolic function in coronary artery disease effects of revascularization on exercise-induced ischemia.
      ,
      • Mann T.
      • Goldberg S.
      • Mudge G.H.
      • Grossman W.
      Factors contributing to altered left ventricular diastolic properties during angina pectoris.
      ,

      Sigwart U, Gribic M, Payot M, Goy J-J, Essinger A, Fischer A. Ischemic events during coronary balloon obstruction. In: Rutishauser W, Roskamm H, eds. Silent Myocardial Ischemia. Heidelberg, Germany: Springer-Verlag, 1984:29–36

      It is conceivable that impaired or stunned regional diastolic function follows transient severe myocardial ischemia associated with coronary vasospasm. To date, the postischemic process of normalization of regional diastolic function in patients with coronary vasospasm has not been investigated. We hypothesized that the adverse effect of spasm-induced ischemia on regional diastolic function would persist well beyond the ischemic event. Color kinesis (CK) (Philips Medical Systems, Andover, Massachusetts), a new technique based on acoustic quantification, has recently been developed to facilitate the evaluation of regional wall motion.
      • Pérez J.E.
      • Waggoner A.D.
      • Barzilai B.
      • Melton H.E.
      • Miller J.G.
      • Sobel B.E.
      On-line assessment of ventricular function by automatic boundary detection and ultrasonic backscatter imaging.
      ,
      • Lang R.M.
      • Vignon P.
      • Weinert L.
      • Bednarz J.
      • Korcarz C.
      • Sandelski J.
      • Koch R.
      • Prater D.
      • Mor-Avi V.
      Echocardiographic quantification of regional left ventricular wall motion with color kinesis.
      The present study was designed to investigate whether impaired regional LV wall motion or diastolic asynchrony could actually be diagnosed using this method, and, if so, how long the regional diastolic dysfunction persists after coronary vasospasm.
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