Identification of transient and persistent segmental wall motion abnormalities in patients with unstable angina by two-dimensional echocardiography.

To determine the value of real-time, two-dimensional echocardiography (2-D echo) in unstable angina, regional wall motion on serial short-axis 2-D echo recordings was analyzed and summed segment scores of abnormal motion were compared and classified according to each patient's clinical status 12 weeks after hospital discharge. Nineteen male patients who fulfilled criteria for unstable angina and responded to medical therapy underwent 2-D echo study within 48 hours of admission and discharge. Of 11 patients with abnormal 2-D echo scores on admission, five patients had reduced scores and six patients had similar or increased scores at discharge. Six of eight patients who had scores of zero on admission had scores of zero at discharge. At follow-up, 11 patients had minimal or no angina pectoris (group 1), and eight patients had worsening angina or recurrent unstable angina (group 2). At discharge, 2-D echo studies showed that all group 1 patients had reduced or zero scores, while group 2 patients retained or increased their abnormal scores. This study shows that in patients with unstable angina, both transient and persistent abnormalities can be identified by 2-D echo. Abnormal segmental wall motion was transient or absent in patients with a good outcome, and worsened or remained abnormal in patients with a poor outcome.