Accuracy of visual assessment of left ventricular wall motion abnormalities by echocardiography

Objective To compare the accuracy of visual evaluation of wall motion abnormalities(WMA) by two-dimensional echocardiography (2DE) with contrast left ventriculography (LVG) in a prospective and blinded study. Methods The study group consisted of 114 patients undergoing elective coronary angiography and LVG. Echocardiograms were recorded one hour before angiography and were visually analyzed in 16 segments. Each segment was assigned to either anterior or inferior regions. Segmental wall motion was graded as normal, hypokinetic, akinetic or dyskinetic. Anterior and inferior wall motions were assessed from LVG using the same grading system as that of 2DE. Results Compared with the results of LVG, the sensitivity, specificity and accuracy of 2DE for detecting anterior WMA were 77%, 97% and 93% and for inferior WMA, 50%, 93% and 81%, respectively. Spearman's rank correlation coefficient was calculated showing that there was a good correlation between 2DE and LVG grading results for both anterior and inferior wall motion (r = 0.77 and 0.50, respectively; both P < 0.0001). Conclusion 2DE visual assessment is accurate for detecting and grading the severity of WMA, especially for the anterior wall.