Evaluation of wall motion abnormality by comparing values of cardiac output obtained by M-mode and Doppler echocardiography: Parameter revealing wall motion abnormality in stress echocardiography.

Dobutamine and dipyridamole stress echocardiographies are both well able to detect myocardial ischemia resulting from coronary diseases by recognizing the regional wall motion abnormality (WMA). Here we report a method for describing WMA in detail. In pharmacological stress echocardiography, because of difficulties in recognizing the two-dimensional pattern, accuracy sometimes depends upon the skill of the operator. Two stroke volumes obtained using the M-mode and Doppler methods were examined to detect abnormal regional cardiac function by the dipyridamole stress test. Stroke volume obtained by the M-modereflects regional cardiac function and that estimated from the outflow using the Doppler methodreflects total cardiac function. These two stroke volumes were compared in normal subjects and patients with coronary-diseases. The results indicated consistent discrepancies between these two stroke volume in the ischemic hearts as a results of coronary stenosis, whereas changes in stroke volumes in the normal subjects showed the same tendency. This method of combining information about the regional and total functions is thus useful in examining the WMA and regional cardiac function, although it can not be applied to subjects whose stroke volume does not increase under stress.