Two-dimensional echocardiographic demonstration of restoration of normal wall motion after acute myocardial infarction.

Left ventricular wall motion was assessed by 2-dimensional (2-D) echocardiography in 17 patients admitted with a first transmural acute myocardial infarction (AMI). The left ventricular myocardium was divided into 17 segments and wall motion was scored from 1 (dyskinesia) to 6 (hyperkinesia) in each segment. Reproducibility of the wall motion scoring system when assessed separately by 2 observers was 89% and when assessed by the same observer at different times, 91%. Seven patients had anterior and 10 inferior wall AMI on the electrocardiogram. Abnormal wall motion was present in 7.3 +/- 2.8 segments (mean +/- standard deviation) on the initial 2-D echocardiogram. On follow-up echocardiograms wall motion was unchanged in 7 patients. In 5 wall motion improved by at least 2 in 2 or more contiguous segments. In 5 other patients wall motion returned to normal in all segments that had shown an abnormality on the initial echocardiogram. These 5 patients (group A), compared with the 12 patients in whom wall motion did not return to normal in all segments (group B), showed fewer involved segments (5.4 +/- 1.7 vs 8 +/- 2.8) and a higher total wall motion score (76 +/- 4 vs 63 +/- 7) (p less than 0.05) on the initial echocardiogram. Duration from the time of the AMI to return of normal wall motion in group A varied from 2 to 8 weeks. Thus, wall motion abnormalities seen on 2-D echocardiography after transmural AMI often improve and wall motion returns to normal in some patients.