Specification of regional wall motion abnormalities by phase analysis of radionuclide angiograms in coronary artery disease and non-coronary artery disease patients.

Fourier transform of gated radionuclide ventriculograms (RNV) permits the quantitative evaluation of regional wall motion abnormalities (RWMA) regarding both regional magnitude (amplitude display) and regional time sequence of contraction (phase display). In this study, an attempt was made to further specify coronary artery disease (CAD) and non-CAD RWMA detected on consecutive exercise RNV in 17 patients (pts) with proven severe CAD; or on resting RNV in 24 pts with transmural myocardial infarction (MI) compared with 27 pts after treatment with daunorubicin (DAU). RWMA were defined objectively from parametric images by a decrease of the sectorial amplitude by more than 2 s.d.s of normal as determined by quantification of RNV studies of 20 normal individuals. In 15 out of 17 CAD pts (88%) and in 19 out of 24 MI pts (79%), a significantly decreased regional amplitude was found. Importantly, in all abnormal CAD and MI amplitude scans (100%), a significantly abnormal phase delay in the same region could be noted. In five out of 27 pts on DAU (18%) an apical hypokinesis could be verified. In comparison with CAD pts, however, the phase distribution was normal in all these DAU pts. Thus, standardized phase analysis of RNV data provides a powerful tool for specifying RWMA. It allows a highly specific separation of RWMA caused by exercise-induced ischemia, MI, or DAU.