Left Ventricular Wall Motion Index Research Articles

Clinical and prognostic importance of persistent precordial (V1-V4) electrocardiographic ST segment depression in patients with inferior transmural myocardial infarction.

Forty-three consecutive patients with acute inferior transmural myocardial infarction but no history or electrocardiographic evidence of prior myocardial infarction were evaluated prospectively to assess the clinical and prognostic importance of persistent precordial (V1-V4) ST segment depression. Patients were evaluated within 24 hr of admission by history, physical examination, cardiac enzyme levels, right heart catheterization, and radionuclide angiography; all were followed for 1 year. Ten of the 43 patients (group I) had persistent anterior precordial ST segment depression, defined as 1 mm or greater in one or more precordial leads (V1-V4) 24 hr after admission to the coronary care unit, and 33 patients (group II) did not. Clinical variables that differed between groups I and II, respectively, included mean age (67 +/- 9 [+/- 1 SD] vs 59 +/- 8 years; p less than .01), incidence of Killip class II to IV (100% vs 33%; p less than .001), and average peak creatine kinase concentration (2878 +/- 1139 vs 1511 +/- 1034 IU/liter; p less than .001). Hemodynamic differences between groups I and II included a higher pulmonary arterial wedge pressure (19 +/- 4 vs 11 +/- 5 mm Hg; p less than .001) and a lower cardiac index (2.0 +/- 0.5 vs 2.6 +/- 0.7 liters/min/m2; p less than .05). An evaluation of left ventricular ejection fraction and wall motion index by radionuclide angiography showed that group I had a lower ejection fraction (44 +/- 11% vs 53 +/- 10%; p less than .05) and higher wall motion index (1.7 +/- 0.4 vs 1.4 +/- 0.3; p less than .05) compared with group II.(ABSTRACT TRUNCATED AT 250 WORDS)

Value of noninvasive techniques for predicting early complications in patients with clinical class II acute myocardial infarction

Twenty-six consecutive patients with acute clinical class II myocardial infarction were prospectively evaluated to assess the ability of two-dimensional echocardiography and gated equilibrium radionuclide angiography to predict early morbidity and mortality. Within 48 hours of the onset of symptoms, right heart catheterization, two-dimensional echocardiography and radionuclide angiography were performed. Serious in-hospital complications developed in 7 patients (27%, Group I), while the remaining 19 patients (Group II) had no complications. Mean left ventricular stroke work index was the only hemodynamic variable that differed significantly between Group I and Group II (28 +/- 8 [standard deviation] vs. 39 +/- 13 g-m/m2, respectively, p less than 0.02). Also, Group I compared with Group II had a significantly lower mean left ventricular ejection fraction by two-dimensional echocardiography (26 +/- 5 vs. 51 +/- 10%, p less than 0.001) or by radionuclide angiography (29 +/- 9 vs. 46 +/- 12%, p less than 0.001). Similarly, Group I had a higher average wall motion index than Group II by both techniques (2.2 +/- 0.2 vs. 1.7 +/- 0.3, p less than 0.001 by two-dimensional echocardiography, and 2.1 +/- 0.3 vs. 1.7 +/- 0.3, p less than 0.001 by radionuclide angiography). Selected stepwise multiple regression analysis demonstrated that left ventricular ejection fraction or wall motion index, by two-dimensional echocardiography or radionuclide angiography, had additional value to a history of prior myocardial infarction for predicting in-hospital complications in patients with class II infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparative study of two—dimensional echocardiography and systolic time intervals in the evaluation of left ventricular function in coronary heart disease

In this study, we attempt to analyze the data of two-dimensional echocardiography and systolic time intervals in 21 patients with documented coronary artery disease. No dysfunction of ventricular wall motion was found in any of the 4 patients with angina pectoris at rest. Abnormal segmental ventricular wall motions were observed in the other 17 patients with myocardial infarction. The apical region was involved in 13 cases and the dyskinesis accounted for 33.9 per cent of the total number of abnormal segments. Left ventricular wall motion index was closely correlated with systolic time intervals, including PEP, LVET and PEP/LVET. The correlation coefficients were-0.72, 0.85 and-0.80 respectively. It has been suggested that left ventricular wall motion index is a valuable one for evaluating left ventricular function and that systolic time intervals can reflect indirectly the presence and severity of abnormal ventricular segmental motion in patients with myocardial infarction.