Asynchronous left ventricular wall motion early after XXXX .

@entity1 @entity1538 @entity1563 @entity2915 @entity158 @entity1186 @entity583 @entity715
To study regional wall motion early in the development of @entity583 , left ventriculograms performed in 24 @entity1 before thrombolysis and within 3.5(1.2) (mean (SD] hours of the onset of @entity158 were digitised frame by frame. Isometric and contour plots of regional wall motion were constructed. In 19 @entity1 (seven with anterior descending, eight with right, and four with circumflex disease) @entity715 was demonstrated on an underlying stenosis. In 10 @entity1 the two remaining coronary arteries were normal, and in nine, one or both showed important disease. Mean values of global indices of left ventricular function, including end diastolic volume, ejection fraction, peak ejection and filling rates, and cavity shape changes were all within normal limits, though end systolic volume was significantly raised. Total systolic amplitude of wall motion was normal in the affected area in all but seven @entity1 (four with anterior descending, two with right, and one with circumflex @entity715 ). Dyskinesis of more than 2 mm was seen in only three @entity1 , all with @entity715 of the anterior anterior descending coronary artery, and @entity2915 was present in four. The commonest abnormality of wall motion was hypokinesis during ejection followed by prolonged inward motion during isovolumic relaxation, which was seen in four @entity1 with anterior descending, seven with right, and three with circumflex artery @entity715 . This was preceded by outward motion during isovolumic contraction and delayed inward motion during ejection in eight with right or circumflex @entity715 . Five of six @entity1 without @entity715 had @entity1538 or dyskinesis without asynchrony. Disease of other coronary arteries did not affect the pattern of wall motion seen after right or circumflex @entity1563 but it reduced the incidence of delayed inward motion along the free wall after @entity715 of anterior descending artery. Thus early after acute @entity1186 asynchronous wall motion is commoner than @entity1538 or dyskinesis. Its persistence suggests that in the setting of @entity1186 in @entity1 , residual contractile activity may persist for up to six hours after the onset of symptoms.
