Comparison of contrast angiography and two-dimensional echocardiography for the evaluation of left ventricular regional wall motion abnormalities after acute myocardial infarction.

Regional left ventricular wall motion abnormalities were assessed using 2-dimensional echocardiography and contrast ventriculography within 12 hours of the onset of chest pain in 20 patients with acute myocardial infarction (AMI); 10 patients had anterior infarctions and 10 had inferior. End-diastolic and end-systolic sinus beats from right anterior oblique contrast ventriculograms were analyzed using the center-line chord technique with both a standard overlap method of chord assignment and a nonoverlap method. Echocardiograms were obtained in parasternal long- and short-axis and apical 2- and 4-chamber views and analyzed using a 16-segment scoring system to derive anterior and infero-posterolateral wall motion indexes using both overlap (10 segments for anterior, 8 inferior) as well as nonoverlap (9 segments anterior, 7 inferior) methods of segment assignment. There was a significant inverse correlation between the standard (nonoverlap) echocardiographic analysis and the standard (overlap) angiographic analysis for infarct regions (y = -0.43 X +1.11, r = -0.59, p less than 0.05). Fifteen of 18 patients with angiographic infarct regional score less than or equal to -1 standard deviation/chord had an echocardiographic index greater than or equal to 1.5, while 15 of 16 patients with echocardiographic regional infarct index greater than or equal to 1.5 had an angiographic score less than or equal to -1 standard deviation/chord. Correlation between the 2 methods for noninfarct territories was poor (r = -0.34) because the angiographic method assesses hyperkinesis while the echocardiographic method does not.(ABSTRACT TRUNCATED AT 250 WORDS)