Key result
RV dysfunction affects ~76% of anterior STEMI cases and tracks with worse LV impairment and remodeling.
Why the study?
Speckle tracking imaging has not been widely used to evaluate right ventricular function in patients undergoing primary PCI for anterior STEMI.
What is the prevalence and significance of right ventricular dysfunction assessed by speckle-tracking imaging in patients with anterior STEMI undergoing primary PCI?
Cross-Sectional (n=50)
No
What is the prevalence and significance of right ventricular dysfunction assessed by speckle-tracking imaging in patients with anterior STEMI undergoing primary PCI?
Right ventricular dysfunction is highly prevalent in patients with anterior STEMI and serves as a marker for a severe biventricular injury phenotype.
RV dysfunction may warrant echo evaluation in anterior STEMI; leaves open its independent prognostic value and need for prospective validation.
Background: Anterior ST-elevation myocardial infarction (STEMI) occurs when a major coronary artery becomes blocked. Because of this, the left ventricle, the heart's primary pumping chamber, suffers serious damage. Rapid reopening of the blocked artery is the goal of emergency angioplasty, sometimes called primary percutaneous coronary intervention (PPCI). Aim: To use speckle tracking imaging to evaluate RV function in patients receiving primary percutaneous coronary intervention (PCI) for anterior ST-segment elevation myocardial infarction (STEMI). Patients and methods: This cross-sectional analytic study was conducted on 50 patients at the Cardiology Department of Al-Azhar University Hospitals, a tertiary center with 24/7 primary PCI capability. The study population consisted of patients with a first acute anterior STEMI, diagnosed by clinical, ECG (ST-elevation in V1-V4), and troponin criteria. The study population was classified into two groups according to the presence of RV dysfunction assessed by RV-GLS. Results: Group 1 had significantly worse LV systolic function (lower LVEF, worse LV GLS, higher wall motion score index), greater LV remodeling (larger end-systolic volume), and more pronounced LV diastolic dysfunction (higher E/e' ratio and larger left atrial volume index). The strong association between worse LV GLS and RV dysfunction underscores the pathophysiological link of ventricular interdependence. Conclusion: Right ventricular dysfunction, as detected by speckle-tracking echocardiography (RV free wall longitudinal strain, RVFWLS), is a prevalent (76%), subclinical, and prognostically significant component of anterior STEMI. It is not an isolated finding but rather a marker of a severe biventricular injury phenotype, characterized by proximal left anterior descending artery occlusion, larger infarct size, worse left ventricular systolic and diastolic dysfunction, and greater ventricular remodeling.
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Bedawy et al. (2026) conducted a cross-sectional in Anterior ST-segment elevation myocardial infarction (STEMI) (n=50). Right ventricular dysfunction assessed by RV-GLS vs. Absence of right ventricular dysfunction was evaluated on LV systolic function, LV remodeling, and LV diastolic dysfunction. Right ventricular dysfunction is a prevalent (76%) component of anterior STEMI and is strongly associated with worse left ventricular systolic and diastolic dysfunction and greater remodeling.
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