Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1984 May;51(5):545–552. doi: 10.1136/hrt.51.5.545

Incoordinate left ventricular wall motion after acute myocardial infarction. Serial echocardiographic assessment.

J R Dawson, G C Sutton
PMCID: PMC481546  PMID: 6721948

Abstract

Serial simultaneous M mode echocardiograms, phonocardiograms, and apexcardiograms were recorded and digitised in 20 patients with a first myocardial infarction immediately after and two, three, seven, and 56 days after hospital admission. Left ventricular maximum and minimum dimensions, normalised maximum rate of change of dimension during systole and diastole, and three previously defined indices of the coordination of left ventricular wall motion were measured. Incoordinate left ventricular wall motion was detected in all patients but was more pronounced in those with an anterior infarction (15) than in those with an inferior infarction (5). Although on the first three days after admission patients with heart failure (7) were indistinguishable echocardiographically from those without (13), differences became apparent later with an increase in left ventricular dimension and more pronounced evidence of incoordination in those with heart failure. In the first two days after admission patients with full thickness infarcts (14) were indistinguishable echocardiographically from those with partial thickness infarcts (6) despite the former being of much larger size as judged by the measurement of cardiac enzyme activity. Abnormal indices of coordination reverted to normal with time in patients with partial thickness infarctions, whereas only partial reversion of these indices occurred in those with full thickness infarctions. The use of digitised M mode echocardiograms is a sensitive means of detecting and following the evolution of incoordinate left ventricular wall motion in patients with an acute myocardial infarction whatever the position, type, or size of the infarct. Incoordination so detected is, however, quantitatively unrelated to infarct type or size or to the clinical state of the patient.

Full text

PDF
545

Images in this article

547Image
on p.547

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chen W., Gibson D. Relation of isovolumic relaxation to left ventricular wall movement in man. Br Heart J. 1979 Jul;42(1):51–56. doi: 10.1136/hrt.42.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Corya B. C., Rasmussen S., Knoebel S. B., Feigenbaum H., Black M. J. Echocardiography in acute myocardial infarction. Am J Cardiol. 1975 Jul;36(1):1–10. doi: 10.1016/0002-9149(75)90859-0. [DOI] [PubMed] [Google Scholar]
  3. Dawson J. R., Sutton G. C. Detection of clinically significant coronary artery disease in hypertensive patients. Echocardiographic study. Br Heart J. 1981 Dec;46(6):595–602. doi: 10.1136/hrt.46.6.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Doran J. H., Traill T. A., Brown D. J., Gibson D. G. Detection of abnormal left ventricular wall movement during isovolumic contraction and early relaxation. Comparison of echo- and angiocardiography. Br Heart J. 1978 Apr;40(4):367–371. doi: 10.1136/hrt.40.4.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eaton L. W., Weiss J. L., Bulkley B. H., Garrison J. B., Weisfeldt M. L. Regional cardiac dilatation after acute myocardial infarction: recognition by two-dimensional echocardiography. N Engl J Med. 1979 Jan 11;300(2):57–62. doi: 10.1056/NEJM197901113000202. [DOI] [PubMed] [Google Scholar]
  6. Falsetti H. L., Marcus M. L., Kerber R. E., Skorton D. J. Quantification of myocardial ischemia and infarction by left ventricular imaging. Circulation. 1981 Apr;63(4):747–751. doi: 10.1161/01.cir.63.4.747. [DOI] [PubMed] [Google Scholar]
  7. Gibson D. G., Brown D. Measurement of instantaneous left ventricular dimension and filling rate in man, using echocardiography. Br Heart J. 1973 Nov;35(11):1141–1149. doi: 10.1136/hrt.35.11.1141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gibson D. G., Doran J. H., Traill T. A., Brown D. J. Regional abnormalities of left ventricular wall movement during isovolumic relaxation in patients with ischemic heart disease. Eur J Cardiol. 1978 Jun;7 (Suppl):251–264. [PubMed] [Google Scholar]
  9. Heger J. J., Weyman A. E., Wann L. S., Dillon J. C., Feigenbaum H. Cross-sectional echocardiography in acute myocardial infarction: detection and localization of regional left ventricular asynergy. Circulation. 1979 Sep;60(3):531–538. doi: 10.1161/01.cir.60.3.531. [DOI] [PubMed] [Google Scholar]
  10. Heger J. J., Weyman A. E., Wann L. S., Rogers E. W., Dillon J. C., Feigenbaum H. Cross-sectional echocardiographic analysis of the extent of left ventricular asynergy in acute myocardial infarction. Circulation. 1980 Jun;61(6):1113–1118. doi: 10.1161/01.cir.61.6.1113. [DOI] [PubMed] [Google Scholar]
  11. Heikkil J, Nieminen M. Echoventriculographic detection, localization, and quantification of left ventricular asynergy in acute myocardial infarction. A correlative echo- and electrocardiographic study. Br Heart J. 1975 Jan;37(1):46–59. doi: 10.1136/hrt.37.1.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hutchins G. M., Bulkley B. H., Ridolfi R. L., Griffith L. S., Lohr F. T., Piasio M. A. Correlation of coronary arteriograms and left ventriculograms with postmortem studies. Circulation. 1977 Jul;56(1):32–37. doi: 10.1161/01.cir.56.1.32. [DOI] [PubMed] [Google Scholar]
  13. Kerber R. E., Marcus M. L., Ehrhardt J., Wilson R., Abboud F. M. Correlation between echocardiographically demonstrated segmental dyskinesis and regional myocardial perfusion. Circulation. 1975 Dec;52(6):1097–1104. doi: 10.1161/01.cir.52.6.1097. [DOI] [PubMed] [Google Scholar]
  14. Lieberman A. N., Weiss J. L., Jugdutt B. I., Becker L. C., Bulkley B. H., Garrison J. G., Hutchins G. M., Kallman C. A., Weisfeldt M. L. Two-dimensional echocardiography and infarct size: relationship of regional wall motion and thickening to the extent of myocardial infarction in the dog. Circulation. 1981 Apr;63(4):739–746. doi: 10.1161/01.cir.63.4.739. [DOI] [PubMed] [Google Scholar]
  15. Mathey D., Biefield W., Hanrath P., Effert S. Attempt to quantitate relation between cardiac function and infarct size in acute myocardial infarction. Br Heart J. 1974 Mar;36(3):271–279. doi: 10.1136/hrt.36.3.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Nieminen M., Heikkilä J. Echoventriculography in acute myocardial infarction. III. Clinical correlations and implication of the noninfarcted myocardium. Am J Cardiol. 1976 Jul;38(1):1–8. doi: 10.1016/0002-9149(76)90054-0. [DOI] [PubMed] [Google Scholar]
  17. Smith M., Ratshin R. A., Harrell F. E., Jr, Russell R. O., Jr, Rackley C. E. Early sequential changes in left ventricular dimensions and filling pressure in patients after myocardial infarction. Am J Cardiol. 1974 Mar;33(3):363–369. doi: 10.1016/0002-9149(74)90317-8. [DOI] [PubMed] [Google Scholar]
  18. Venco A., St John Sutton M. G., Gibson D. G., Brown D. J. Non-invasive assessment of left ventricular function after correction of severe aortic regurgitation. Br Heart J. 1976 Dec;38(12):1324–1331. doi: 10.1136/hrt.38.12.1324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Visser C. A., Lie K. I., Kan G., Meltzer R., Durrer D. Detection and quantification of acute, isolated myocardial infarction by two dimensional echocardiography. Am J Cardiol. 1981 May;47(5):1020–1025. doi: 10.1016/0002-9149(81)90207-1. [DOI] [PubMed] [Google Scholar]
  20. Wyatt H. L., Forrester J. S., da Luz P. L., Diamond G. A., Chagrasulis R., Swan H. J. Functional abnormalities in nonoccluded regions of myocardium after experimental coronary occlusion. Am J Cardiol. 1976 Mar 4;37(3):366–372. doi: 10.1016/0002-9149(76)90285-x. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES