Fig. 6

Illustration of differences in longitudinal, septal and lateral contributions to left ventricular pumping in a patient with LAD-MI (top row) and RCA-MI (bottom row). Cine images in the left-ventricular outflow tract view are shown in end diastole (left column) and end systole (middle column) and the corresponding late gadolinium enhancement (LGE) images (right column, c and f) show the extent of the infarcted area (arrows). The solid white outline of the LV in end diastole (a and d) is superimposed on the images in end systole (b and e) where the ventricles in end systole have been outlined with a dashed line. The AV-plane displacement (AVPD) is the difference of the horizontal white line at base of LV in end-diastole and end-systole and marked by double arrow at the base of ventricle in e. Longitudinal pumping is the difference in the basal contours at end diastole and end systole. Radial pumping is caused by the displacement of the epicardial border from end diastole and end systole. Note in b that the lateral component of radial pumping is increased (arrow at lateral wall in b) and compensates for the decreased longitudinal and septal contributions to LV pumping. As a contrast, the RCA-MI patient shown in the lower panels has a normal AVPD despite the MI. This may be compensatory to the decreased lateral contribution to LVSV in this patient due to the MI