Echocardiographic assessment of left atrioventricular plane displacement as a complement to left ventricular regional wall motion evaluation in the detection of myocardial dysfunction.
OBJECTIVE
We aimed to find out if abnormal left atrioventricular plane displacement (AVPD) is a sign of myocardial dysfunction, even in patients with normal left ventricular (LV) regional wall motion (RWM).


METHODS
We prospectively performed echocardiography in 1350 consecutive patients referred to our echocardiography laboratory. Left AVPD and LV RWM were evaluated in all patients. We prospectively selected all patients with normal LV RWM but impaired left AVPD for further analysis of clinical parameters.


RESULTS
Eighty-eight of the 1350 patients had completely normal LV RWM but impaired left AVPD (< or = 10 mm) in at least one region (septal, lateral, posterior, anterior). Of these, 60.2% had prior and/ or acute myocardial infarction, predominantly non-Q-wave, whereas 33.0% had angina without infarction and 2.3% had hypertension. In 49 (55.7%) patients coronary angiography was performed. All were abnormal. In 4.5% (n = 4) of the patients no obvious reason for the AVPD decrease was found, but was not precluded.


CONCLUSIONS
Almost all patients with abnormal left AVPD and completely normal LV RWM had clinical cardiac disease. Thus, decreased AVPD despite normal LV RWM seems to be a true sign of myocardial dysfunction, predominantly indicating subendocardial dysfunction. In screening for patients with myocardial dysfunction assessment of left AVPD may be useful as a complement to LV RWM evaluation. The prognosis in such patients is currently being evaluated.
Willenheimer
Ronnie
R
Department of Cardiology, Malmö University Hospital, Lund University, Sweden. ronnie.willenheimer@medforsk.mas.lu.se
Rydberg
E
E
Stagmo
M
M
Gudmundsson
Petri
P
Ericsson
Gerd
G
Erhardt
Leif
L
D000368:Aged; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D016277:Ventricular Function, Left / Q000502:physiology*