Correlation of regional wall motion after acute myocardial infarction with coronary arteriographic findings

Changes of wall motion after acute myocardial infarction (MI) were compared with stenosis (>50%) of major vessels on coronary arteriography (CAG) performed within 4 weeks. Multigated blood-pool scans were obtained within 15 hours of MI and at 10 days in 37 patients who received standard therapy. Regional wall motion was quantitatively analyzed as mean chord shortening (MCS) in 6 sector segments (60 degrees) in the anterior and LAO views. Akinetic segments (AkS: MCS≤15%) (n=97) and normal segments (NS: MCS≥30%) (n=68) at the initial scan were selected for this study. Ten days after MI, MCS in AkS increased (6.0 +- 13.4%;p<0.001), whereas MCS in NS decreased (-7.0 +- 13.6%; p<0.001). The MCS changes in these segments were compared with CAG findings in multivessel disease (MVD) (n=20) and single-vessel disease (SVD) (n=17). SVD showed significant MCS change both in AkS and NS (p<0.001 each). This change was marked in RCA/Cx disease in SVD (p<0.001 each). These data suggest 1) improvement of AkS at 10 days after MI was more often seen in SVD. 2) Among SVD, their improvement was higher in RCA/Cx than LAD. 3) NS showed higher wall motion at the acute stage than 10 days after MI. 4) This hyperkinetic wall motion in NS was more often seen in SVD