Coronarographie and Ventriculographic Correlates of the Scintigraphic Picture of Inferior Wall Myocardial Infarction

Abstract

Inferior wall myocardial infarction (IMI) is linked to an anatomic damage of various extension. In order to evaluate the relation among TI-scintigraphy, coronary involvement and left ventricular function, 72 patients with previous IMI (3-11 months) were studied. All patients showed a nonreversible defect in the inferior wall at planar TI-scintigraphy; patients with lateral or with associated anterior defects were excluded. Patients underwent a hemodynamic and angiographic study within 4 weeks from TI-scintigraphy. Patients were grouped according to TI-scintigraphy as follows: inferoapical (IA) 13 patients; posterolateral (PL) 24 patients; diaphragmatic (D) 22 patients; large (two or more locations; L) 13 patients. Results showed a greater incidence of significant stenoses of left anterior descending artery in IA and L patients while PL patients showed a greater incidence of lesions of the left circumflex artery. All the subsets showed a significant decrease in ejection fraction with a larger hypokinetic area in L patients. Wall motion analysis in IA patients showed the involvement of anterobasal, apical and inferior regions, in D and PL patients of the diaphragmatic and posterobasal regions; L patients showed an apical, diaphragmatic and posterobasal hypokinesis. In conclusion, in previous IMI, TI-scintigraphy indicates patients with high probability of multivessel disease (L and IA), with circumflex artery involvement (PL) and with more extensive left ventricular damage (L).