Pathoanatomic correlates of regional left ventricular wall motion assessed by equilibrium radionuclide angiocardiography: a postmortem correlation.
The pathoanatomic correlates of qualitative assessment of regional wall motion (RWM) on routine equilibrium radionuclide angiocardiography (ERNA) were evaluated in 62 patients who had ERNA within 3 months before they died. Of 51 patients with abnormal RWM, 46 (90%) had gross myocardial lesions at autopsy. Of 11 patients with normal RWM, 9 (82%) had normal myocardium. Complete agreement of RWM with postmortem findings in all left ventricular segments occurred in 32% of the patients. Compared with postmortem findings, abnormal RWM on ERNA overestimated the number of macroscopically abnormal segments in 21% of the patients and underestimated in 47%. Of 372 segments analyzed, the overall sensitivity, specificity and predictive value of abnormal RWM on ERNA for detecting gross myocardial infarction or fibrosis was 73%, 75% and 83%, respectively. There were 35 false-positive segments (9%) (15 patients). In 27 of these segments (77%), severe stenosis of the coronary artery supplying the segment or electrocardiographic left bundle branch block could explain these findings. There were 61 false-negative segments (16%) (30 patients). In 55 of these segments (90%), either nontransmural infarction or masking by severe adjacent asynergy provided a potential explanation. Thus, qualitative analysis of RWM on routine ERNA correlates well with postmortem findings.(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D001344:Autopsy; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology*; D011877:Radionuclide Imaging