This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wilkins, G. T. Articles by Weyman, A. E. Search for Related Content PubMed PubMed Citation Articles by Wilkins, G. T. Articles by Weyman, A. E.

Circulation, Vol 77, 978-987, Copyright © 1988 by American Heart Association

ARTICLES

Correlation between echocardiographic endocardial surface mapping of abnormal wall motion and pathologic infarct size in autopsied hearts

GT Wilkins, JF Southern, CY Choong, JD Thomas, JT Fallon, DE Guyer and AE Weyman
Cardiac Unit of the Massachusetts General Hospital, Boston.

We previously developed a cross-sectional echocardiographic technique for quantitatively mapping the endocardial surface of the left ventricle and on which regions of abnormal wall motion can be superimposed in their correct spatial distribution. This endocardial mapping technique (EMT) provides a measure of the left ventricular endocardial surface area (ESA in cm2), the area of abnormal wall motion (AWM in cm2), and the overall percent dysfunction (%AWM) as a measure of the functional "infarct size." To test this approach, we compared the EMT measurements with the actual endocardial surface area (in cm2) and pathologic infarct size (both percent infarct by volume and percent endocardial surface overlying infarct) measured at later autopsy in 20 adults (14 men, six women) ranging in age from 47 to 76 years (mean 64 +/- 9.6 years). The median interval from echocardiographic study to death was 19 days (range 1 to 269 days). Patients were divided into two groups based on the age of their infarcts at the time of death: (1) recent (infarct age less than 14 days; mean age 5.3 +/- 4.6 days) and (2) old (infarct age greater than 6 months; mean age 3.6 +/- 3 years). When the left ventricular endocardial surface area at autopsy was compared with the EMT-derived ESA, a close correlation was found (EMT area = 1.17 X autopsy area + 20.4; r = .94, p = .0001), with the systematic difference in the measurements accounted for by systolic arrest, loss of distending pressure, and specimen shrinkage. The echocardiographic measure of infarct size (%AWM) correlated well with the autopsy percent infarction by volume (%AWM = 1.1 X infarct volume + 5.5; r = .82, p = .0001). Similarly, a good correlation was found for the percent abnormal wall motion and the autopsy percent endocardial surface area overlying infarction (%AWM = 0.89 X infarct area - 0.9; r = .89, p = .0001). When the data were examined in relation to the age of the myocardial infarct, the echocardiographic %AWM appeared to overestimate the autopsy infarct size (by percent infarct volume) in the recent infarct group (n = 6), and underestimate the extent in the old infarct group (n = 13). The findings suggest that the EMT will provide a useful quantitative measure of left ventricular endocardial surface area and the extent of ischemic/infarct-related dysfunction.

This article has been cited by other articles:

				M. Scherrer-Crosbie, W. Steudel, R. Ullrich, P. R. Hunziker, N. Liel-Cohen, J. Newell, J. Zaroff, W. M. Zapol, and M. H. Picard Echocardiographic determination of risk area size in a murine model of myocardial ischemia Am J Physiol Heart Circ Physiol, September 1, 1999; 277(3): H986 - H992. [Abstract] [Full Text] [PDF]