Comparison of contrast medium and atrial pacing as tests of ventricular function in coronary artery disease.

Ventricular function curves were constructed in 39 patients having coronary arteriography by plotting left ventricular end-diastolic pressure and stroke work index before, during, and immediately after atrial pacing. Similar curves were constructed from measurements obtained before and 3 minutes after a standard left ventricular angiogram. Both methods vary preload sufficiently to produce detectable changes in stroke work index, atrial pacing by decreasing the diastolic filling period, and contrast by increasing venous return. The 2 methods were compared for their relative sensitivity in detecting abnormal ventricular function in coronary artery disease. Atrial pacing ventricular function curves were obtained from 8 patients with no heart disease. The left ventricular end-diastolic pressure decreased from