The relationship between the character of regional wall motion abnormality and the degree of myocardial perfusion abnormality of myocardial infarction

We evaluated the relationship between the regional wall motion and regional myocardial ischemia in fourteen patients with myocardial infarction by dividing the left ventricular image into eight sections. We analyzed regional wall motion by a new method of gated blood pool scan analysis and we divided it into five types: N: normal, 1: remarkably low wall movement, 2: low wall movement, 3: phase abnormality and 4: low wall movement with phase abnormality. We analyzed myocardial perfusion by the circumferential profile method of exercise 201Tl myocardial scintigram and classified myocardial perfusion as normal perfusion, hypoperfusion and defect. Our new method of regional wall motion analysis was shown to be useful because it could detect 95% of the areas of myocardial hypoperfusion and defect. Furthermore, regional wall motion abnormality was observed in normal perfusion areas at a high rate too. The areas of low wall movement with phase abnormality were observed more frequently with increasing severity of ischemia and the areas with defect image were closely correlated with a high degree of phase abnormality. We concluded that the type of regional wall motion with myocardial infarction is related to myocardial perfusion but regional wall motion abnormality cannot be explained on the basis of presence or absence of ischemia or the degree of its severity. (author)