[Normal ranges of the regional movement of the left ventricular wall in 2-dimensional echocardiography]

Two-dimensional echocardiographic (2D-Echo) studies were performed in 51 healthy subjects to set up normal ranges of regional left ventricular (LV) wall motion for three different standard planes: the short axis (SA), recorded at a level between the mitral valve and the papillary muscles, the apical two-chamber view (2 CV) and the apical four-chamber view (4 CV). Wall motion analysis was performed using a fixed (Fix) as well as a floating reference system (Float). For regional wall motion, calculated by segmental area shortening, tolerance limits were estimated by using two well established statistical methods. The lowest coefficient of variation (V) was found for the SA (VFix = 0.18; VFloat = 0.11). The apical planes showed higher variations (2 CV: VFix = 0.20, VFloat = 0.20; 4 CV: VFix = 0.26, VFloat = 0.19). Defining the normal LV contraction ranges, a comparison of the reference systems showed advantages of the floating procedures, mainly in the SA and in the 4 CV. The obtained normal contraction ranges can be used for the evaluation of regional LV contraction abnormalities after acute myocardial infarction (AMI) if the 2D-Echo images are of excellent quality. We suggest an "index of dyssynergy" as a measure of wall motion abnormality.