Key result
Anterior STEMI linked to reduced RA reservoir and conduit function despite preserved contraction.
Why the study?
Changes in left ventricular systolic and diastolic functions may affect right atrial phasic functions, but their status during acute anterior STEMI compared with controls required evaluation.
Does anterior ST-elevation myocardial infarction impair right atrial phasic functions compared to matched controls?
Case-Control (n=123)
No
Does anterior ST-elevation myocardial infarction impair right atrial phasic functions compared to matched controls?
Absolute Event Rate: 30.5% vs 33.2%
p-value: p=0.021
In patients with anterior STEMI, right atrial reservoir and conduit functions are reduced, and preserved RA contraction function is predictive of a lower risk of mortality or reinfarction.
Reduced RA reservoir/conduit strain after anterior STEMI was associated with higher event risk; extends LA strain data but remains hypothesis-generating.
BACKGROUND: Evidence suggests that changes in left ventricular systolic and diastolic functions may affect right atrial (RA) phasic functions. We aimed to evaluate RA phasic functions in the presence of anterior ST-elevation myocardial infarction (ASTEMI) as an acute event and to compare the findings with those in a control group. METHODS: We recruited 92 consecutive ASTEMI patients without accompanying significant stenosis in the proximal and middle parts of the right coronary artery and 31 control subjects, matched for age, sex, diabetes, and hypertension. RA phasic functions were evaluated concerning their longitudinal 2D speckle-tracking echocardiography-derived markers. The ASTEMI group was followed up for all-cause mortality or reinfarction. RESULTS: In the ASTEMI group, RA strain was reduced during the reservoir (33.2% ± 4.3% vs 30.5% ± 8.1%; P = 0.021) and conduit (16% [12-18%] vs 14% [9-17%]; P = 0.048) phases. The other longitudinal 2D speckle-tracking echocardiography-derived markers of RA phasic functions were not different between the 2 groups. RA strain and strain rate during the contraction phase were predictive of all-cause mortality or reinfarction (hazard ratio = 0.80; P = 0.024 and hazard ratio = 0.39; P = 0.026, respectively). CONCLUSIONS: Based on 2D speckle-tracking echocardiography, in the ASTEMI group, compared with the control group, RA reservoir and conduit functions were reduced, while RA contraction function was preserved. RA contraction function was predictive of all-cause mortality or reinfarction during the follow-up period.
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Eisvand et al. (2022) conducted a case-control in Anterior ST-elevation myocardial infarction (ASTEMI) (n=123). Anterior ST-elevation myocardial infarction (ASTEMI) vs. Matched control subjects without significant coronary artery stenosis was evaluated on Right atrial strain during the reservoir phase (RASr) (p=0.021). Anterior ST-elevation myocardial infarction was associated with reduced right atrial reservoir strain (30.5% vs 33.2%) and conduit functions compared to matched controls, while contraction function was preserved.
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