Key result
Anterior STEMI was associated with significantly worse right ventricular dysfunction compared to inferior STEMI, as evidenced by lower tricuspid annular plane systolic excursion and strain (p≤0.0001).
Why the study?
The study aimed to determine whether imaging reveals right ventricular involvement beyond standard ECG and to compare right ventricular function between anterior and inferior MI without ECG-evident RV involvement.
Does anterior STEMI cause worse subclinical right ventricular dysfunction compared to inferior STEMI in patients undergoing primary percutaneous coronary intervention?
Cross-Sectional (n=100)
No
Does anterior STEMI cause worse subclinical right ventricular dysfunction compared to inferior STEMI in patients undergoing primary percutaneous coronary intervention?
Anterior STEMI is associated with worse subclinical right ventricular dysfunction compared to inferior STEMI, even without ECG evidence of RV involvement.
May warrant closer RV monitoring after anterior STEMI; leaves open prognostic impact and need for prospective trials.
This study hypothesized that imaging provides information indicating the right ventricular (RV) involvement after anterior or inferior ST-elevation myocardial infarction (STEMI), beyond standard electrocardiogram (ECG) due to the increasing interest in RV function and assessment techniques. This study aimed to compare RV function between anterior and inferior MI without RV involvement using different echocardiographic modalities. This study included 100 patients with anterior (50 patients) and inferior (50 patients) STEMI, who underwent primary percutaneous coronary intervention (PPCI) and two-dimensional echocardiographic imaging within 24 h after PPCI with RV function analysis by left ventricular (LV) infarct size, LV filling pressure, and RV strain rate. Our primary endpoint was the subclinical RV dysfunction in anterior or inferior MI using tissue Doppler and speckle tracking (STE). The study population included 80 (80%) males and 20 (20%) females. Patients with the anterior STEMI had higher mean creatine kinase-MB (CKMB) and troponin than those with inferior STEMI. This study revealed worse RV dysfunction in patients with anterior than those with inferior STEMI, as reflected by significantly lower RV systolic function, tricuspid annular plane systolic excursion (p ≤ 0.0001), tissue Doppler-derived velocity (p ≤ 0.0001), and STE-derived strain magnitude and rate (p ≤ 0.0001). RV dysfunction occurs in patients without ECG evidence of RV STEMI. RV dysfunction is worse in anterior than inferior MI. Moreover, RV systolic functions were affected by declined LV ejection fraction irrespective of the infarction site, which clinically implies prognostic, treatment, survival rate, and outcome improvement between both conditions. (Trial registration ZU-IRB#:4142/26-12-2017 Registered 26 December 2017, email: IRB_123@medicine.zu.edu.eg).
No takes yet. Share an insight, caveat, or question.
Radwan et al. (2022) conducted a cross-sectional in ST-elevation myocardial infarction (STEMI) (n=100). Anterior STEMI vs. Inferior STEMI was evaluated on Subclinical right ventricular dysfunction assessed by tissue Doppler and speckle tracking echocardiography (p=≤0.0001). Anterior STEMI was associated with significantly worse right ventricular dysfunction compared to inferior STEMI, as evidenced by lower tricuspid annular plane systolic excursion and strain (p≤0.0001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: