Quantification of left ventricular wall dysfunction by M-mode echocardiographic mapping in heart failure following acute myocardial infarction.

Echocardiographic mapping was performed in 44 patients on arrival in hospital and day 2 following acute myocardial infarction (AMI). To evaluate left ventricular (LV) function the per cent deviation of the mean systolic wall velocity (PD-V) from the normal was measured from 16 LV segments. Adequate data were obtained from 89% of the segments. The number of hypokinetic segments was somewhat higher in anterior than inferior AMI, reaching significance (p less than 0.05) on day 2. Dyskinetic segments were also more common in patients with anterior infarction (p less than 0.001), who also had significantly higher enzyme maxima than patients with inferior AMI (p less than 0.01). Enzyme maxima correlated well with the sum of PD-V from all hypokinetic segments on day 1 (r = 0.79, p less than 0.01). Compensatory hyperkinesia was more common in inferior than anterior AMI (p less than 0.001). Global LV function, estimated by subtracting the number of hyper- from hypokinetic segments (score sigma S:Adj), was significantly related to heart failure (Killip classification) (p less than 0.01) and the respiratory rate (r = 0.71, p less than 0.01) in the acute phase as well as to heart failure during the first post AMI month (New York Heart Association classification).