Comparative accuracy of cross-sectional echocardiography and cineventriculography for left ventricular evaluation after myocardial infarction.

223 patients with a previous myocardial infarction (MI) 29-68 years old, have been studied in a double-blind manner both by 2D-Echocardiography and cineventriculography. 5 cross-sectional views and 2 angiographic projections have been employed in order to assess the presence of aneurysm and the motion of the left ventricle. The left ventricle has been divided into 5 anatomic regions: interventricular septum, anterolateral, posterolateral, apical and inferior walls. By cineangiography an aneurysm was diagnosed in 89 patients (one pseudoaneurysm); by 2D-Echo in 83 patients an aneurysm was diagnosed, whereas in the 6 remaining patients the Echocardiogram was nondiagnostic (specificity 100%, sensitivity 93%). Concerning regional motion characteristics, 997 (89%) of 1115 regions were visualized and 905 (91%) correctly identified according to the angiographic findings. Of 92 discrepancies (9%): 64 were attributed to 2D-Echo (69%) and 28 (31%) were attributed to cineangiography; most of the discrepancies attributed to echo resulted from minor grades of asynergy which caused unresolved disagreements between the Echo and angiography findings. It is concluded that Cross-sectional echocardiography is a valuable tool for the diagnosis of aneurysm of the left ventricle (specificity 100% and sensitivity 93%) and for the study of wall motion characteristics. In cases with generalized abnormality of left ventricle motion, resulting in a picture of congestive cardiomyopathy, 2D-Echo can be a substitute for cineangiography. In all other instances both techniques can provide more complete information on ventricular wall abnormalities.