Detection and quantification of acute, isolated myocardial infarction by two dimensional echocardiography

• Published in: The American journal of cardiology Vol. 47; no. 5; pp. 1020 - 1025
• Main Authors: Visser, Cees A., Lie, Kong Ing, Kan, Gerard, Meltzer, Richard, Durrer, Dirk
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 1981
• Subjects: Adult; Aged; Creatine Kinase - metabolism; Echocardiography - methods; Electrocardiography; Endocardium - physiopathology; Female; Heart Ventricles - pathology; Humans; Isoenzymes; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardium - enzymology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(81)90207-1

Ninety consecutive patients with acute, isolated myocardial infarction were evaluated with two dimensional echocardiography. Satisfactory echocardiograms were obtained in 66 patients (73 percent). All patients were studied 2 to 12 hours after the onset of symptoms. Sixty patients had additional studies at 48 and 72 hours. Long axis views were obtained at the base, body and apex of the left ventricle. Five short axis views of the left ventricle were obtained at different levels from the cardiac base to the apex. The individual short axis views, corrected for the end-diastolic internal diameter of the left ventricle, were divided into equal segments and the area of asynergy in each view was estimated.
Infarct localization was similar on electrocardiography and echocardiography in 62 of 66 patients. In two patients the sites differed. Localization was possible only with two dimensional echocardiography in one patient. The results of an echocardiographic study in one patient were false negative. During the study period the individual asynergic area remained stable. The initial asynergic area correlated well (r = 0.87, p <0.01) with the peak value of the isoenzyme of creatine kinase (CK-MB), which occurred hours later. Thus, two dimensional echocardiography is a reliable method to localize and quantify, early after the onset of symptoms, the eventual extent of myocardial involvement in patients with acute, isolated infarction.