[Localized disorders of left ventricular wall motion in congestive cardiomyopathy (author's transl)]

Left ventricular wall motion was studied by two-dimensional echocardiography in 11 patients with congestive cardiomyopathy and was compared with the data of the electrocardiogram and cardiac catheterization. A segmental analysis of left ventricular wall motion was performed using 9 segments obtained by short- and long-axis views of the left ventricle. Left ventricular volume and ejection fraction were calculated from the apical long-axis view by area-length method. Asynergy such as dyskinesis or akinesis was detected in 8 of the 11 patients. Two patients with complete left bundle branch block had asynergy in the septal, anterior and apical segments. In 3 patients with abnormal Q waves inI, aVL and V5,6, asynergy was observed in the different area of the left ventricle in addition to the corresponding region with EKG abnormalities. However, in 3 patients, asynergy occurred without any Q waves. The left ventricle with asynergy had an increased left ventricular end-diastolic volume and left ventricular end-diastolic pressure and a decreased ejection fraction as compared to those without asynergy. As congestive cardiomyopathy had high incidence of asynergy, it was difficult to differentiate congestive cardiomyopathy from ischemic heart disease by two-dimensional echocardiography.