Comparison of contrast angiography and two-dimensional echocardiography for the evaluation of left ventricular regional wall motion abnormalities after acute myocardial infarction

Craig Lundgren, Patrick D.V. Bourdillon, James C. Dillon, Harvey Feigenbaum

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Regional left ventricular wall motion abnormalities were assessed using 2-dimensional echocardiography and contrast ventriculography within 12 hours of the onset of chest pain in 20 patients with acute myocardial infarction (AMI); 10 patients had anterior infarctions and 10 had inferior. End-diastolic and end-systole sinus beats from right anterior oblique contrast ventriculograms were analyzed using the center-line chord technique with both a standard overlap method of chord assignment and a nonoverlap method. Echocardiograms were obtained in parasternal long- and short-axis and apical 2- and 4-chamber views and analyzed using a 16-segment scoring system to derive anterior and infero-posterolateral wall motion indexes using both overlap (10 segments for anterior, 8 inferior) as well as nonoverlap (9 segments anterior, 7 inferior) methods of segment assignment. There was a significant inverse correlation between the standard (nonoverlap) echocardiographic analysis and the standard (overlap) angiographic analysis for infarct regions (y = -0.43 × + 1.11, r = -0.59, p < 0.05). Fifteen of 18 patients with angiographic infarct regional score <- -1 standard deviation/ chord had an echocardiographic index ≥1.5, while 15 of 16 patients with echocardiographic regional infarct index ≥1.5 had an angiographic score <--1 standard deviation/chord. Correlation between the 2 methods for noninfarct territories was poor (r = -0.34) because the angiographic method assesses hyperkinesis while the echocardiographic method does not. For noninfarct regions, 13 of 16 patients with an angiographic score >-1 standard deviation/chord had an echocardiographic index <1.5, while 13 of 15 patients with an echocardiographic regional index of <1.5 had an angiographic score >-1 standard deviation/chord. In comparing overlap and nonoverlap methods, significant differences were found for noninfarct regions but not for infarct regions for both echocardiographic and angiographic analyses. Data indicate that 2-dimensional echocardiography, which is non-invasive and more easily repeatabte for serial studies, yields similar results to contrast angiography for the assessment of regional wall motion abnormalities after AMI.

Original languageEnglish (US)
Pages (from-to)1071-1077
Number of pages7
JournalThe American journal of cardiology
Issue number16
StatePublished - May 1 1990


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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