2000 Volume 31 Issue 2 Pages 171-182
Severe stenosis of a non-infarct-related artery may cause regional remote ventricular asynergy during the acute phase of myocardial infarction (MI). Such lesions may contribute to left ventricular dysfunction and poor prognosis following MI. We performed two-dimensional echocardiography in 140 patients with their first acute anterior MI on admission and 1 month after MI. Using the modified centerline method, the left ventricular short axis image was used to determine % wall thickening (%WT) of the left anterior descending artery (LAD) area, the right coronary artery (RCA) area, and the left circumflex artery (LCX) area. The study compared the accuracy of %WT and visual assessment of wall motion for the diagnosis of remote coronary stenosis. Of the 140 patients, 100 had single-vessel disease occurring in the LAD (group S) and 40 had multivessel disease (group M). In group M, remote asynergy in the non-infarcted area was identified in 33 patients (83%) by abnormal %WT and in 16 (40%) by abmormal wall motion (p<0.001). The %WT of the RCA area was lower in group M than in group S (p<0.0001). The %WT of the LCX area was also lower in group M than in group S (p<0.0001). The %WT in the non-infarcted area improved 1 month after the onset of MI (p<0.0001). %WT determined by two-dimensional echocardiography and the modified centerline method is more sensitive than visual assessment of wall motion for the identification of multivessel disease in patients with acute anterior wall MI.
