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Subxiphoid echocardiographic assessment of left ventricular wall in old myocardial infarction
Insights
Echocardiography effectively assesses left ventricular wall motion after myocardial infarction. Combining subxiphoid and parasternal views improves detection of asynergic areas, enhancing myocardial damage evaluation.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Myocardial infarction (MI) can lead to left ventricular (LV) dysfunction.
- Accurate assessment of LV wall motion is crucial for managing post-MI patients.
Purpose of the Study:
- To evaluate the utility of standard and subxiphoid echocardiography in assessing LV wall motion in patients with old MI.
- To correlate echocardiographic findings with coronary angiography and electrocardiography.
Main Methods:
- Cineangiography, standard echocardiography (parasternal approach), and subxiphoid echocardiography were performed on 50 MI patients and 10 controls.
- Left ventricular wall motion and asynergic areas were analyzed.
Main Results:
- Coronary angiography correlated well with ECG-indicated infarction sites and asynergic areas found by cineventriculography and 2D echocardiography.
- Subxiphoid echocardiography visualizes the posterior-lateral wall, while parasternal views show the posterior-inferior wall.
- Subxiphoid 2D echocardiography effectively detects apical asynergies.
- M-mode echocardiography revealed significant LV wall motion abnormalities in MI patients compared to controls.
- Combining subxiphoid (SUBX) and parasternal (ST) approaches provides comprehensive information on LV wall motion and myocardial damage extent.
Conclusions:
- Subxiphoid echocardiography is a valuable tool for evaluating LV lateral wall asynergies.
- The combined use of subxiphoid and parasternal echocardiographic views enhances the assessment of myocardial damage extent post-MI.
Abstract:
We studied by cineangiography and standard and subxiphoid echocardiography the left ventricular wall motion in 50 patients with old myocardial infarction and 10 normal subjects. Coronary artery angiography showed a good correlation with the electrocardiographic site of infarction and with the asynergic areas detected by cineventriculographic examination and bidimensional echocardiography. From the correlation of data related to the asynergic areas detected by angiographic and echocardiographic methods it was possible to establish that subxiphoid approach allows to visualize the posterior-lateral wall whereas the parasternal approach the posterior-inferior wall of the left ventricle. Two-dimensional echocardiography from the subxiphoid approach resulted to be a useful and reliable technique for detecting the apical asynergies. The left ventricular wall motion parameters detected by M-mode echocardiography showed significant modifications in all the groups either in the comparison SUBX versus ST or in that with the control group. The subxiphoid approach either M-mode or bidimensional was, therefore, useful in the evaluation of the asynergic areas of the left ventricular lateral wall. The association of SUBX with ST provides further information on the left ventricular wall motion and then, since different areas are visualized with the two techniques, on the extent of myocardial damage.