Key result
TAPSE and S' accurately detect RV involvement and predict culprit lesions in acute inferior MI.
Why the study?
Right ventricular infarction adds risk and high mortality in acute ST elevation IWMI, necessitating prompt non-invasive investigative correlates to guide early intervention.
Do right ventricular systolic echocardiographic indices accurately detect right ventricular involvement and predict angiographic culprit lesions in patients with acute ST elevation inferior wall myocardial infarction?
Observational (n=104)
Do right ventricular systolic echocardiographic indices accurately detect right ventricular involvement and predict angiographic culprit lesions in patients with acute ST elevation inferior wall myocardial infarction?
Right ventricular systolic echocardiographic indices, particularly TAPSE and S', can serve as accurate non-invasive tools to detect right ventricular involvement and predict the culprit lesion in acute inferior wall myocardial infarction.
May aid non-invasive RV assessment in inferior MI; leaves open prospective validation before routine adoption.
Objectives: Right ventricular infarction (RVI) poses as an added risk factor in patients presenting with acute ST elevation inferior wall myocardial infarction (IWMI) with considerable high mortality. An early interventional therapeutic strategy after a prompt and accurate non-invasive investigative correlate is needed. Material and methods: We sampled 104 patients diagnosed with inferior wall infarction presenting with angina within 12 hours of angina. Investigations included routine blood investigation, 12 lead and right precordial lead electrocardiography, right ventricular (RV) systolic echocardiographic indices, and coronary angiography. Results: Majority of the patients had angiographic evidence of a dominant distal right coronary artery (RCA) culprit lesion. Those patients having ST elevation in RV4 lead had significantly higher incidences of RVI and high-grade atrio-ventricular (AV) blocks. Elderly diabetic patients with azotemia and deranged liver function predicted RVI among the study population. RV systolic indices like TAPSE was most accurate and S’ was found to be most specific in detecting RVI. Chi square test and multivariate regression analysis of echocardiographic parameters like RVDD, RVMPI, and S’ proved excellent surrogate non-invasive surrogate markers for specific angiographic culprit lesions. Conclusion: RV systolic echocardiographic indices shows a diagnostic accuracy of variable degrees in detecting right ventricular involvement in IWMI patients and also act as a surrogate marker in predicting the culprit lesion.
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Ghosh et al. (2022) conducted an observational in Acute ST elevation inferior wall myocardial infarction (n=104). Echocardiography and electrocardiography vs. Coronary angiography was evaluated on Detection of right ventricular involvement and prediction of culprit lesion. Echocardiographic indices like TAPSE and S' accurately detected right ventricular involvement and predicted specific angiographic culprit lesions in acute inferior wall myocardial infarction.