Pathoanatomic correlates of regional left ventricular wall motion assessed by equilibrium radionuclide angiocardiography: a postmortem correlation.

The pathoanatomic correlates of qualitative assessment of regional wall motion (RWM) on routine equilibrium radionuclide angiocardiography (ERNA) were evaluated in 62 patients who had ERNA within 3 months before they died. Of 51 patients with abnormal RWM, 46 (90%) had gross myocardial lesions at autopsy. Of 11 patients with normal RWM, 9 (82%) had normal myocardium. Complete agreement of RWM with postmortem findings in all left ventricular segments occurred in 32% of the patients. Compared with postmortem findings, abnormal RWM on ERNA overestimated the number of macroscopically abnormal segments in 21% of the patients and underestimated in 47%. Of 372 segments analyzed, the overall sensitivity, specificity and predictive value of abnormal RWM on ERNA for detecting gross myocardial infarction or fibrosis was 73%, 75% and 83%, respectively. There were 35 false-positive segments (9%) (15 patients). In 27 of these segments (77%), severe stenosis of the coronary artery supplying the segment or electrocardiographic left bundle branch block could explain these findings. There were 61 false-negative segments (16%) (30 patients). In 55 of these segments (90%), either nontransmural infarction or masking by severe adjacent asynergy provided a potential explanation. Thus, qualitative analysis of RWM on routine ERNA correlates well with postmortem findings.(ABSTRACT TRUNCATED AT 250 WORDS)