[Comparison of the postmortem anatomical study and bidimensional echocardiography in myocardial infarction]

We studied 10 patients between the ages of 30 and 69 years, all of whom had suffered myocardial infarction (MI) at least 6 months before they died. Two-dimensional echocardiography (2-D E) and catheterism were done no more than 15 days before death. The location and extension of MI were compared to the segmentary mobility (SM), end diastolic wall thickness (EDWT) and percentage of systolic wall thickening (PSWT) determined by 2-D E, in the 15 segments of the left ventricular wall. We also compared 2-D E and coronariographic findings. There was a good correlation between the location (P less than 0.01) and extension (P less than 0.05) of the necrotic area dyssynergy, specially when the MI was transmural. The postmortem measurement of the wall thickness in each one of the segments had also good correlation with the EDWT as measured with 2-D E (r = 0.926). The EDWT was less in the necrotic segments (8.8 +/- 1.8 mm) than in non affected segments (14.1 +/- 1.9 mm) and this difference was significant (P less than 0.05). The wall was thinnest in segment affected by transmural necrosis. The PSWT was significantly less (P less than 0.01) in necrotic segments (12.1 +/- 3%) than in segments without necrosis (24.1 +/- 4.3%). The alteration of SM correlated with coronary obstructions greater than 75%, specially when it was associated with necrosis. The EDWT was less in necrotic segments with important coronary artery obstruction than in those without necrosis even though vascular narrowing was marked (P less than 0.01). The PSWT was also less in the areas with necrosis when coronary obstruction was severe as well as moderate (11.3 +/- 2.3%) than in segments with coronary obstruction but without necrosis (22.3 +/- 4.2%) and even less than that obtained in cases with neither coronary artery obstruction nor necrotic area (30.1 +/- 2.2%) and the difference is statistically significant (P less than 0.01). The segmentary measurement by 2-D E of the EDWT and the PSWT are useful for recognizing areas with necrosis and differentiating it from ischemic areas of left ventricle in coronary artery disease.