[Short-axis views of left ventriculograms compared with two-dimensional echocardiograms in cases of ischemic heart...

We examined 115 cases of ischemic heart disease to re-evaluate the usefulness and limitations of two-dimensional echocardiography in diagnosing left ventricular asynergy. Short-axis left ventriculography (SA-LVG) using the LAO-caudal angulated projection was performed and their findings were compared with those of the short-axis views of two-dimensional echocardiograms (SA-2DE). Left ventricular (LV) walls the SA-LVG and SA-2DE were divided into the interventricular septum (IVS), the anterior (AW), posterior (PW) and inferior wall segments (IW), and the manifestations of SA-LVG and SA-2DE were compared, corresponding to the four segments. A total of 414 (90%) of the 460 segments were correctly diagnosed by SA-2DE. Among 132 akinetic segments shown by SA-LVG, 123 (93%) revealed akinesis by SA-2DE, and 279 (96%) of 292 angiographically-normal segments also showed normal movement by SA-2DE. However, only 11 segments (35%) of all 32 angiographic hypokinesis were correctly diagnosed by SA-2DE. Thus, SA-2DE was fairly sensitive and useful in diagnosing akinesis and identifying normal contraction. However, it had limitation in diagnosing hypokinesis, as we previously reported.