Increased left ventricular volume following myocardial infarction in man

To determine the relationship between left ventricular volumes and the magnitude of wall motion abnormality in the chronic post myocardial infarction period, the right anterior oblique left ventriculogram was analyzed in 55 patients with left anterior descending coronary artery disease. The size of the infarct segment was determined by measuring the percentage of the circumference of the left ventricular silhouette that was akinetic and/or dyskinetic. Four groups of patients were defined with increasing degrees of wall motion abnormality based on the percent of the diastolic perimeter that was akinetic and/or dyskinetic. Marked increases in end-diastolic and end-systolic volumes were observed across groups of increasing wall motion abnormality. These large increases in volume could not be accounted for by an increase in filling pressures. Ejection fraction fell in proportion to the increase in wall motion abnormality across groups. This study demonstrated that in the chronic phase of infarction, left ventricular remodeling results in alterations in left ventricular volumes that are proportional to the degree of wall motion abnormality.