The Value of Tissue Doppler Imaging in Prediction of Multivessel Disease in Patients with Acute Inferior Myocardial Infarction Treated by Thrombolytic Therapy

OBJECTIVE: Acute inferior myocardial infarctions AIMI consists the 40-50% of all ST elevated MI. Studies have showed that the rate of multivessel disease MVD is 40-45% in AIMI. Our study was designed to investigate whether tissue Doppler imaging can be used to determine MVD in patients with AIMI who were treated by thrombolytic therapy.METHODS: 49 patients with AIMI who were admitted to our hospital and refused primary percutaneous angioplasty were enrolled in this study. Pateints were treated with streptokinase as a thrombolytic therapy. All patients underwent to two dimensional echocardiographic and pulse wave tissue Doppler imaging examination on the day of admission and evaluated by coronary angiography within 10 days of admission. Patients with one vessel disease consisted the group I and patients with 2 or 3 vessel disease consisted the group II. Tissue Doppler imaging was performed and Sm, SmVTİ, Em, Am, Em/Am, DT, Q-Sm, CT, IVRT values were estimated.RESULTS: In our study group, 45% of patients were found to have MVD. The differences between the groups according to traditional Doppler parameters and LVEF were not significant. Tissue Doppler imaging showed that in group II when compared to group I; Sm, Em, Em/Am values were reduced, whereas DT, Q-Sm, IVRT values were increased. In regression analyses mitral lateral and septal Sm were found to be independant indicators of MVD.CONCLUSION: We argued that the tissue Doppler imaging can be a usefull tool as a non invasive method for determining of MVD in patients with AIMI