Evaluative value of TAPSE in anterior STEMI patients

Background Tricuspid annular plane systolic excursion (TAPSE) may be used to assess early RV dysfunction in anterior STEMI patients, knowing the possibility of major adverse cardiovascular events (MACE) development. Purpose We evaluated TAPSE in anterior and non-anterior STEMI patients after percutaneous coronary intervention (PCI). Methods In this study we included one hundred and one consecutive patients with inclusion criteria for STEMI: a) persistent chest pain, b) an electrocardiogram (ECG) with new ST elevation at the J-point in at least two contiguous leads, c) increased hs-cardiac troponin (hs-cTn) (ESC 0h/1h and 0h/2h algorithms), and d) patients who underwent pPCI (persistent ST-segment elevation and symptoms of ischemia of ≤ 12 h duration). Also, the creatine kinase (CK), the MB fraction of creatine kinase (CK-MB), CRP, and other routine laboratory parameters were measured. Echocardiographic assessment was done using TAPSE, average MAPSE, GLS, EF and etc. . Patients were divided in two groups according to the myocardial infarct location (anterior and non-anterior STEMI). Results In total 47 (46.54%) patients suffered from anterior STEMI (the mean of TAPSE was 17.48 (±2.9)) and 54 (53.46%) of patients with non-anterior STEMI had a mean TAPSE of 18.85 (±2.67) (p = 0.02). As far as, the mean value of left ventricular global longitudinal strain (LV GLS) in anterior STEMI was -7.7 (±5.08) and -11.77 (±3.15) in non-anterior STEMI (p=0.001) (Table 1). A significant correlation was observed between TAPSE and LV GLS (p=0.019) (Fig. 1). Conclusions Assessment of early RV dysfunction by TAPSE is important even in anterior STEMI patients requiring a rigorous management approach because the possibility of the short-term MACE development.