Regional left ventricular wall motion assessment: comparison of two-dimensional echocardiography and radionuclide angiography with contrast angiography in healed myocardial infarction.

The diagnostic ability of radionuclide angiography (RNA) and 2-dimensional echocardiography (2-D echo) to assess regional left ventricular (LV) wall motion was compared with contrast angiography in 52 patients with healed myocardial infarction. After 5 patients were excluded for inadequate 2-D echocardiographic studies, the LV images of 47 patients obtained by all 3 techniques were divided into 7 segments for analysis. Both 2-D echo and RNA showed close agreement with contrast angiography in assessing normal vs abnormal wall motion in the anterobasal (91%, 91%), anterolateral (87%, 79%) and posterolateral segments (77%, 79%). The sensitivity in detecting wall motion abnormalities was highest for 2-D echo and RNA in the anterolateral (83%, 77%) and apical (95%, 84%) segments and lowest for the inferior segment (48%, 48%). Specificity of 2-D echo and RNA was high, ranging from 94% in the anterolateral segment to 71% in the septal segment for 2-D echo, and from 91% in the inferior segment to 81% in the posterobasal and septal segments for RNA. Major discrepancies with contrast angiography occurred more often in the posterobasal, posterolateral, inferior and septal LV segments. Thus, in comparison with contrast angiography, 2-D echo and RNA are reliable for detecting anterior and apical wall motion abnormalities, but relatively less sensitive for detecting wall motion abnormalities involving the inferior, posterobasal and posterolateral LV segments.