: Correlation of regional wall motion abnormality and coronary angiography in first acute anterior myocardial infarction

Abstract

The aim of this study was to evaluate the correlation of regional wall motion abnormality (RWMA) detected by 2D echocardiography and coronary angiographic findings in patients with first AAMI.Method:In a prospective crossectional study admission electrocardiography (ECG) was obtained from patients with first AAMI. Coronary angiography (CAG) and if needed primary percutaneous intervention (PPCI) or facilitated primary percutaneous intervention (PCI) were performed within 3 days after admission. Angiographic findings including lesion size, location, severity and TIMI grade flow of LAD artery lesions were recorded. Transthoracic 2D echocardiography was done within 24 hours after CAG or PCI and presence of RWMA in 18 left ventricular segments was evaluated.Results:86 patients were men and 14 patients were female. We found less involvement, in some of LAD supplying segments including: basal anterior (7%), mid anterior (36%) and basal anteroseptal (47%). patients with diffuse LAD lesions, had correlation with more involvement of midposterior and basal posterior segments (P=0.003 and P<0.001 respectively). The mean sum of ST elevation (sum of STE) in patients with involvement of apicolateral and posteroapical segments were more than patients without involvement ofthese segments (16.6±8.8 vs 10.4±3.4; P<0.001 and 16.6±9.1 vs 12.3±4.7; P<0.001 respectively).There was a nonlinear correlation between number of precordial leads having ST elevation and RWMA in Mid Septal, inferoapical, anteroapical, posteroapical segments, also between sum of STE and LAD lesion size, as well as between presence of ST elevation in lead V5 and LAD lesion size.ST elevation in lead V4 correlated with basal anteroseptal segment RWMA, and in lead V5 with apicoseptal, apicolateral, anteroapical and posteroapical segments RWMA, and in lead V6 with apicolateral, inferoapical, mid anterior, anteroapical and posteroapical RWMA. Therefore ST elevation in leads V5-V6 were associated with apical segments involvement.