Evaluation of the Effect of Therapeutic Interventions Using Two-Dimensional Echocardiography

Although characteristic alterations in myocardial performance in response to regional ischemia were first described by Tennant and Wiggers in 1935 [1], it was not until recently that these experimental findings were defined in detail by means of sophisticated noninvasive measurements. Regional left ventricular dysfunction can be demonstrated within a few cardiac beats after an acute coronary obstruction, and a characteristic sequence of segmental contractile derangements is seen during myocardial infarction. The advent of invasive ventriculography for studies of global and regional cardiac function [2–6], and the more recent nuclear procedures, contributed significantly to the understanding of mechanical consequences of myocardial ischemia. The problem with these techniques is that they do not lend themselves for bedside and sequential evaluation of cardiac performance. M-mode echocardiography has been used for detecting abnormal wall motion in patients with coronary artery disease [7–9], but it also is not satisfactory because of the ‘ice pick’ view which limits imaging of the left ventricle.