Key result
Acute inferior MI is linked to significantly reduced RV GLS versus healthy controls.
Why the study?
Do 2D speckle tracking and tissue Doppler imaging accurately detect right ventricular dysfunction and correlate with proximal RCA stenosis in patients with acute inferior wall myocardial infarction?
Case-Control (n=65)
No
Do 2D speckle tracking and tissue Doppler imaging accurately detect right ventricular dysfunction and correlate with proximal RCA stenosis in patients with acute inferior wall myocardial infarction?
Absolute Event Rate: -12.22% vs -19.77%
p-value: p=<0.0001
Advanced echocardiographic modalities like speckle tracking and TDI can detect significant right ventricular dysfunction in patients with acute inferior MI, particularly those with proximal RCA lesions, even when traditional parameters appear normal.
Speckle tracking may aid post-inferior MI RV assessment; leaves open standardization versus TDI before clinical adoption.
Right ventricular (RV) function, has not been widely studied after acute myocardial infarction (MI). The current study describes the use of recent modalities of echocardiography (Echo) to provide a simple accurate diagnosis of ventricular functions post acute inferior MI.Aims of the study: The assessment of the RV functions in acute inferior wall MI using ventricular strain assessed by 2D longitudinal speckle tracking in comparison to tissue Doppler imaging (TDI) as well as correlation of the results of RV function with the angiographic data of right coronary artery (RCA) stenosis in the first episode of acute inferior wall MI. Patients & methods.In The patient group composed of 45 patients with first episode of acute inferior MI, twenty patients were selected for the control group.All 65 patients underwent echo assessment indices of dimensions, ventricular function (EF, FS and TAPSE), ventricular myocardial velocities by TDI and global longitudinal strain of both ventricle by speckle tracking.Patients were then divided into two groups A and B according to the presence or absence of significant proximal RCA stenosis.Results: The study included 45 patients with first episode of IWMI underwent coronary angiography (group2) and 20 persons as control (group1).TAPSE, TDI derived systolic and early diastolic velocities as well as global longitudinal strain assessed by 2D-speckle tracking all were significantly reduced in patients versus control group.On the other hand, patients with proximal RCA stenosis (group A, 17 patients) compared to non-proximal RCA lesions(group B,28 patients) had significantly lower EF, FS, TAPSE, impaired both systolic and diastolic function of RV including TDI derived velocities and global longitudinal strain which assessed by 2D-speckle tracking.Conclusion: RV functions may be globally significantly reduced in those with first attack of inferior wall MI particularly those with proximal RCA lesions detected by recent modalities of echo even in those with apparently normal traditional echo parameters.
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Mahmoud et al. (2017) conducted a case-control in Acute inferior wall myocardial infarction (n=65). Acute inferior wall myocardial infarction vs. Healthy controls was evaluated on Right ventricular global longitudinal strain (p=<0.0001). Acute inferior wall myocardial infarction was associated with significantly reduced right ventricular global longitudinal strain compared to healthy controls (-12.22 vs -19.77, p<0.0001).
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