Pathoanatomic correlates of regional left ventricular wall motion assessed by equilibrium radionuclide...

The pathoanatomic correlates of qualitative assessment of regional wall motion (RWM) on routine equilibrium radionuclide angiocardiography (ERNA) were evaluated in 62 patients who had ERNA within 3 months before they died. Of 51 patients with abnormal RWM, 46 (90%) had gross myocardial lesions at autopsy. Of 11 patients with normal RWM, 9 (82%) had normal myocardium. Complete agreement of RWM with postmortem findings in all left ventricular segments occurred in 32% of the patients. Compared with postmortem findings, abnormal RWM on ERNA overestimated the number of macroscopically abnormal segments in 21% of the patients and underestimated in 47%. Of 372 segments analyzed, the overall sensitivity, specificity and predictive value of abnormal RWM on ERNA for detecting gross myocardial infarction or fibrosis was 73%, 75% and 83%, respectively. There were 35 false-positive segments (9%) (15 patients). In 27 of these segments (77%), severe stenosis of the coronary artery supplying the segment or electrocardiographic left bundle branch block could explain these findings. There were 61 false-negative segments (16%) (30 patients). In 55 of these segments (90%), either nontransmural infarction or masking by severe adjacent asynergy provided a potential explanation. Thus, qualitative analysis of RWM on routine ERNA correlates well with postmortem findings.(ABSTRACT TRUNCATED AT 250 WORDS)