Echocardiographic Features of Congestive Cardiomyopathy Compared with Normal Subjects and Patients with Coronary Artery Disease

Abstract

Echocardiograms of ten patients with congestive cardiomyopathy were compared to those of three groups of patients: (1) 17 with no catheterization or angiographic evidence of cardiac disease; (2) 19 with 75% or greater obstruction of one or more coronary arteries (CAD); and (3) 8 with previous myocardial infarction and congestive heart failure (CAD-CHF). Echocardiographic values of interest included the left ventricular internal dimension at end-diastole/body surface area (LVIDd index), the amplitudes of the left septal echo (LSa) and posterior endocardial echo (ENa), LSa + ENa, and the maximum rate of rise of the posterior endocardial echo ([See Equation in PDF File]). Septal and posterior wall thicknesses were measured and the presence or absence of pericardial effusion and abnormal mitral valve closure were observed. All of the left ventricular measurements were significantly different when comparing the cardiomyopathy group with the normal and CAD groups. Differentiating cardiomyopathy from the CAD-CHF group was far more difficult with the only highly significant difference being the LSa + ENa ( P < 0.001). Only one cardiomyopathy patient and one CAD-CHF patient had a sum of LSa + ENa overlapping the other group. These results are consistent with the diffuse disease usually seen in congestive cardiomyopathy and the segmental nature of coronary artery disease in which some area of the left ventricle moves well even in the presence of congestive heart failure.