COMPARISON BETWEEN ABNORMALITIES IN SEGMENTAL ENDOCARDIAL MOTION AND ABNORMALITIES IN SEGMENTAL WALL THICKENING AFTER ANTERIOR MYOCARDIAL-INFARCTION - A CINE-MAGNETIC RESONANCE STUDY

In this study, two patterns of regional contraction of the left ventri cle have been studied: endocardial motion and wall thickening, in orde r to check which of these was the most affected after myocardial infar ction. The clinical relevance of this comparison was to assess which p arameter of the regional contraction abnormality would best depict the severity of the infarction. Long axis cine-magnetic resonance slices were used to assess segmental systolic left ventricular endocardial mo tion and segmental systolic wall thickening in 39 normal subjects and in 30 patients at the chronic stage of an anterior myocardial infarcti on. In the group of normal subjects, endocardial motion and wail thick ening showed significant regional heterogeneity. Overall endocardial m otion was greater than overall wall thickening: 9.5 +/- 2.0 mm vs 7.1 +/- 1.8 mm, P=4 x 10(-12) (3.1 +/- 1.2 mm vs 2.0 +/- 0.7 mm, P=9 x 10( -5) after infarction). A significant linear correlation was found betw een these two parameters. In the infarction group, abnormality scores for endocardial motion and for wall thickening were calculated. These scores were defined as the average values exceeding the mean minus two standard deviations of the normal range for segments corresponding to the antero-septal-apical walls. The abnormality score for endocardial motion was greater than the abnormality score for wall thickening: 0. 31 +/- 0.12 vs 0.20 +/- 0.07, P=9 x 10(-4). We conclude that, in clini cal practice, endocardial motion is affected to a greater degree by my ocardial infarction than is wall thickening and therefore constitutes a more discriminant index in the assessment of post-infarction patient s.