Key result
Tissue Doppler-derived peak lateral tricuspid annular systolic velocity <11.9 cm/s and RV-MPI ≥0.50 predicted proximal RCA occlusion in acute inferior myocardial infarction with 80% sensitivity.
Why the study?
Do tissue Doppler parameters (ST and RV-MPI) predict right ventricular infarction and proximal RCA culprit lesion location in patients with acute inferior myocardial infarction?
Observational (n=30)
Do tissue Doppler parameters (ST and RV-MPI) predict right ventricular infarction and proximal RCA culprit lesion location in patients with acute inferior myocardial infarction?
Tissue Doppler imaging parameters (ST < 11.9 cm/s and RV-MPI ≥ 0.5) can non-invasively predict proximal RCA occlusion and right ventricular infarction in patients with acute inferior myocardial infarction.
ST and RV-MPI may aid RVI prediction and proximal RCA localization in inferior MI; leaves open validation in larger prospective cohorts.
This study aims at using peak lateral tricuspid annular systolic velocity (ST) and right ventricular myocardial performance index (RV-MPI) as predictors of RV infarction (RVI) and subsequently localizing the culprit lesion in the proximal right coronary (RCA) rather than other locations [the distal RCA or dominant left circumflex (LCX) artery]. 30 patients suffering from acute inferior infarction, were subjected to early conventional and pulsed wave tissue Doppler echocardiographic examinations, measuring (ST) and calculating RV-MPI. Half of the patients had the culprit lesion proximal to the RV branch of the RCA and the other half had non-proximal RCA occlusion. ST values were significantly reduced in patients with RVI. Cutoff value of ST was found to be 11.9 cm/s with a sensitivity 80.0%, specificity 93.3%, positive predictive value 92.3% and negative predictive value 82.4% in the identification of proximal RCA lesion as the culprit lesion. The calculated RV-MPI was significantly different; its mean value was 0.666 ± 0.118 in the proximal RCA vs. 0.524 ± 0.133 in the non-proximal RCA patients. RV-MPI cutoff value proved to be 0.50 with sensitivity 80%, specificity 66.7%, negative predictive value 76.9% and positive predictive value 70.6%. RVI caused by a proximal RCA lesion could be predicted using TDI to assess ST and RV-MPI from the tricuspid annulus. Patients with ST < 11.9 cm/s and RV-MPI ⩾ 0.5 indicated most probably occlusion of the proximal RCA.
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Adel et al. (2014) conducted an observational in Acute inferior myocardial infarction (n=30). Tissue Doppler echocardiography (ST and RV-MPI) was evaluated on Identification of proximal RCA lesion as the culprit lesion. Tissue Doppler-derived peak lateral tricuspid annular systolic velocity <11.9 cm/s and RV-MPI ≥0.50 predicted proximal RCA occlusion in acute inferior myocardial infarction with 80% sensitivity.