A relationship was examined between the development of myocardial ischemia in patients with coronary heart disease before coronary ventriculography and the status of coronary vessels, coronary reserve, myocardial contractility, and the autonomic nervous system. Before coronary ventriculography, myocardial ischemia was found to occur in the patients when there was a marked activation in the sympathetic portion of the autonomic nervous system and a clear-cut decrease in coronary reserve. The occurrence of myocardial ischemia in the patients before coronary ventriculography contributed to decreased left ventricular myocardial contractility and increased the cardiodepressive effects of a contrast agent.
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