Comparative study of echo- and angiocardiographically determined regional left ventricular wall motion in recent myocardial infarction.

We have studied regional left ventricular (LV) wall motion with M-mode, cross-sectional (2D) echocardiography and LV angiography in 50 patients with a recent myocardial infarction. Regional LV wall motion was evaluated according to a 9-segment model. 2D echocardiography permitted information from all, M-mode echocardiography from 8 and angiocardiography from 6 segments. Wall motion was visually classified according to a 5-grade scale. Systolic mean wall velocity (V mean) and its deviation from normal values was calculated from M-mode registrations. 2D echo- and angiocardiography were evaluated in 35 patients and M-mode echo- and angiocardiography in 37. Total agreement in segmental wall motion was seen in 61% when comparing 2D echo- with angiocardiography, and a further 35% showed 1-grade and 4% a 2-grade difference. Corresponding values for comparisons between M-mode echo- and angiocardiography were 59%, 32% and 9%, respectively. Discrepant wall motion grading from the 2D echo- and angiocardiography comparison was seen in 94 of 243 (38%) segments. Approximately one quarter of the discrepancies were either due to minor differences in evaluation or due to wall motion scoring. Discrepancies were seen in 83 of 202 (41%) segments when M-mode echo- and angiocardiography were compared. In 42 (21%) these were attributed to obvious M-mode errors and in 8 (4%) to left ventricular angiography. In 20 further segments, nonidentical subsegmental evaluations were the probable cause of discrepancies, and in 8 (10%) ischaemia during the angiocardiography. Five segmental discrepancies remained unexplained.