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WESTPORT, CT (Reuters Health) – Three reports published in the September 15th issue of The American Journal of Cardiology shed light on the effects of coronary artery disease on left ventricular structure and function and how revascularization might improve these parameters.

Dr. Miguel Zabalgoitia, from the University of Texas in San Antonio, and colleagues investigated the impact of CAD on LV systolic function and geometry in hypertensive patients with LV hypertrophy. The researchers found that the presence of CAD is a good predictor of LV structural and functional abnormalities.

"To my knowledge, this is the first time that the presence of CAD has been associated with an elevated myocardial oxygen demand index in these patients," Dr. Zabalgoitia told Reuters Health. "The index has been described in the past but it has never been tied to the presence of CAD," he added.

"The patients in the current study were derived from a large study comparing losartan with atenolol for the treatment of hypertension," Dr. Zabalgoitia noted. "Once that study is completed, we will then know which medications the patients in the current study received and whether our findings are related to a specific treatment."

Dr. Roxy Senior, from the Northwick Park Hospital in Harrow, UK, and colleagues assessed LV remodeling in 70 patients with severe chronic ischemic LV dysfunction who underwent revascularization or were treated medically. The revascularization group included 33 patients who underwent bypass grafting and three who underwent angioplasty. All but 16 patients had evidence of viable myocardium.

Revascularized patients showed improvements in regional and global LV function compared with medically treated patients, the researchers found. In addition, revascularization was associated with an improvement in LV geometry independent from the improvement in function.

Regardless of treatment type, the only discriminator between the 15 patients who died and the 55 who did not was change in LV end-systolic volume, the authors note. They suggest that future studies investigating the benefits of revascularization should include not only measures of LV function but also of LV geometry.

Dr. Yuji Hara and colleagues, from Ehime University in Japan, studied 53 patients who underwent angioplasty more than 2 weeks after experiencing their first acute myocardial infarction. Based on angiography results obtained several months later, the patients were divided into a maintained patency group or a restenosis group.

From baseline to followup through a mean of 5.4 months, the LV ejection fractions and LV volumes of the patients with maintained patency improved significantly, while those of the restenosis patients did not change significantly. In addition, patients with maintained patency demonstrated a decrease in B-type natriuretic peptide levels, suggesting an improvement in cardiac function and a decrease in myocardial damage.