Evaluation of Left Ventricular Function in Patients with Aortic Regurgitation Using Afterload Stress

SUMMARY Left ventricular function was assessed in 14 patients with chronic aortic regurgitation by afterload eleva-tion with angiotensin. Seven of 14 patients maintained their resting ejection fraction with angiotensin (group A), while the remaining seven experienced a decline of greater than 0.10 in ejection fraction (group B). Six of seven group A patients showed an appropriate rise in left ventricular stroke work index in response to the angiotensin-induced rise in left ventricular end-diastolic pressure. In contrast, six of seven group B patients showed abnormal, flat, or declining stroke work indices. Included in the seven group B patients were two patients with left ventricular dysfunction secondary to coronary artery disease. The five other group B patients, who did not have coronary disease, exhibited similar stress-induced ventricular dysfunction, despite the absence of an