Regional left ventricular wall motion assessment: comparison of two-dimensional echocardiography and radionuclide angiography with contrast angiography in healed myocardial infarction.
The diagnostic ability of radionuclide angiography (RNA) and 2-dimensional echocardiography (2-D echo) to assess regional left ventricular (LV) wall motion was compared with contrast angiography in 52 patients with healed myocardial infarction. After 5 patients were excluded for inadequate 2-D echocardiographic studies, the LV images of 47 patients obtained by all 3 techniques were divided into 7 segments for analysis. Both 2-D echo and RNA showed close agreement with contrast angiography in assessing normal vs abnormal wall motion in the anterobasal (91%, 91%), anterolateral (87%, 79%) and posterolateral segments (77%, 79%). The sensitivity in detecting wall motion abnormalities was highest for 2-D echo and RNA in the anterolateral (83%, 77%) and apical (95%, 84%) segments and lowest for the inferior segment (48%, 48%). Specificity of 2-D echo and RNA was high, ranging from 94% in the anterolateral segment to 71% in the septal segment for 2-D echo, and from 91% in the inferior segment to 81% in the posterobasal and septal segments for RNA. Major discrepancies with contrast angiography occurred more often in the posterobasal, posterolateral, inferior and septal LV segments. Thus, in comparison with contrast angiography, 2-D echo and RNA are reliable for detecting anterior and apical wall motion abnormalities, but relatively less sensitive for detecting wall motion abnormalities involving the inferior, posterobasal and posterolateral LV segments.
D000368:Aged; D000792:Angiography / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011877:Radionuclide Imaging; D013318:Stroke Volume