[Left ventricular wall motion in ischemic heart disease quantitatively assessed by three-dimensional vectors of reference points in multi-directional two-dimensional echocardiography].

Left ventricular wall motion was analyzed in a spatial geometric manner assuming the quantitative vectors formed by the reference points' movement on two-dimensional echocardiogram in 58 normal subjects and 40 patients with ischemic heart disease. Long-axis, RAO-equivalent and short-axis views, termed sagittal, frontal, and horizontal planes, respectively, were visualized and two or three reference points were defined on each plane. The vectors of these points' movement were obtained from video-image tracings on each plane and systolic excursion and distortion angles of each pair of reference points were vectorially assessed. All vectors in myocardial infarction were directed towards the infarcted areas. Clockwise horizontal distortion of the left ventricle apex-to-base axis was observed in normal subjects, but it was slight (3.1 +/- 3.0 degrees: mean +/- SD at the papillary muscle horizontal section). However, larger horizontal distortion was observed in single coronary artery disease, which may lead to the erroneous segmental wall motion analysis using conventional cineangiography because of the overlap of the adjacent segments.