Regional left ventricular wall motion abnormalities in idiopathic dilated cardiomyopathy.

An evaluation and a comparison of left ventricular regional wall motion were performed in 32 patients with idiopathic dilated cardiomyopathy, none of whom had coronary artery diameter stenosis exceeding 20% in any major artery, and 17 control subjects, using frame by frame video intensity analysis of digitized ventriculograms. This technique evaluates the whole cardiac cycle in short overlapping intervals and yields information for systolic and diastolic events, without assumptions regarding the position and orientation of the ventricle. Diastolic regional wall motion abnormalities were found in 31 of 32 patients and systolic abnormalities were present in 16 patients. Asynchronous regions most commonly detected during diastole were anteroapical and apical; they were found in 19 of 32 patients. Regional contraction abnormality was observed in the apical and the anteroapical regions in 6 of 16 patients. Dilatation-induced changes in left ventricular shape exaggerate the phenomenon of higher wall stress at the apex of the normal ventricle. Basal wall motion is thus relatively preserved in dilated cardiomyopathy.