Cine MRI for the evaluation of influences of regional left ventricular wall motion abnormalities on global cardiac function after myocardial infarction and revascularization therapy.

Purpose: To determine changes in global cardiac function and mass caused by infarct-associated regional wall motion abnormalities and to compare the c hanges after revascularization in patients with and without improvement of regional contractility. Materials and Methods: 21 patients with regional le ft ventricular wall motion abnormalities and associated coronary artery ste noses requiring revascularization were examined with a Cine FLASH-2D sequen ce 26+/-12 days after their first myocardial infarction and re-examined thr ee months after revascularization. Regional contractility and volumes and m asses of both ventricles were determined. Results: After revascularization, regional wall motion improvement led to decreased left ventricular volumes and improved ejection fractions, whereas patients with persisting wail mot ion defects showed unchanged left ventricular functional parameters. Compar ing both groups of patients, the patients with improvement of regional cont ractility revealed lower end-systolic volumes and higher ejection fractions at follow-up. Cardiac masses and right ventricular parameters were not dif ferent, patients with a depressed right ventricular ejection fraction showe d improvement at follow-up. Discussion: After myocardia( infarction, revasc ularization of the infarct-related coronary artery leads to an improvement of left ventricular function only if there is also an improvement of region al contractility. An effect on right ventricular function was not observed three months after the first small- or middle-sized myocardial infarction.