Left ventricular wall motion improvement after successful coronary reperfusion therapy in acute myocardial infarction: prediction by two-dimensional echocardiography]

Two-dimensional echocardiography was performed in 21 patients with acute anterior myocardial infarction who underwent intracoronary reperfusion therapy for the infarct-related left anterior descending coronary artery. The images of left ventricular wall was subdivided into 15 segments according to Heger's classification, and the wall motion of the 6 segments corresponding to the perfusion region was visually inspected before and mean 5.9 weeks after coronary intervention. The patients were categorized in 2 groups on the basis of an increase attained in wall motion score of the 6 segments; a group of patients who improved by an increase of 2 points (14 cases) and those who did not improve, not reaching a 2-point increase (7 cases). Three parameters including wall thickness of the infarcted regions, the ratio of the interventricular septum (IVS) to the posterior wall thicknesses, and the systolic wall thickening rate of the septum measured during the acute phase were compared between the 2 groups. In the improved group, the wall thickness of the infarcted region was 9.1 +/- 1.5 mm; whereas, in the unimproved group it was significantly less (7.6 +/- 1.1 mm). The ratio of the septum to posterior wall thicknesses in the improved group (0.88 +/- 0.12) was significantly greater than that of the unimproved group (0.74 +/- 0.11). No significant difference was observed in the systolic wall thickening rate. We concluded that the measurement of wall thickness of the infarcted region in the acute phase in patients with acute anterior myocardial infarction may be useful for predicting the restoration of wall motion after intracoronary reperfusion therapy.