Sensitivity and Specificity of Myocardial Performance Indexing Assessing Acute Right Ventricular Infarction

Q: What are the key findings of this study?

Right ventricular myocardial performance index (RVMPI ≥ 0.30) diagnosed acute right ventricular infarction with 100% sensitivity and 83.33%-89% specificity (mean 0.57 vs 0.24, p<0.05).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute inferior wall myocardial infarction (with or without right ventricular infarction) (n=72). Intervention: Right Ventricular Myocardial Performance Index (RVMPI ≥ 0.30) vs. Acute inferior myocardial infarction without right ventricular involvement on right-sided ECG. Primary outcome: Right Ventricular Myocardial Performance Index (RVMPI) within 24 hours of admission and diagnostic performance (RVMPI ≥ 0.30) for acute right ventricular myocardial infarction (Sensitivity 100%, Specificity 83.33% (Accuracy 88.89%), p=<0.05).

Q: What does this research mean for the field?

A right ventricular myocardial performance index cutoff of ≥0.30 identifies acute right ventricular infarction in patients with inferior myocardial infarction with high sensitivity and specificity. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine the sensitivity and specificity of the right ventricular myocardial performance index (MPI) for assessing acute right ventricular myocardial infarction in patients with acute inferior myocardial infarction.

Md Rezaul Karim; Md Afzalur Rahman; Rais Uddin Mondol; Tariq Ahmed Chowdhury; Rajesh Kumar Ghose

doi:10.3329/taj.v35i1.61135

August 10, 2022TAJ Journal of Teachers AssociationOpen Access

Sensitivity and Specificity of Myocardial Performance Indexing Assessing Acute Right Ventricular Infarction

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Key result

RVMPI identifies acute right ventricular infarction with 100% sensitivity and ~83% specificity.

Sensitivity +100%, Specificity 83.33% (Accuracy 88.89%)
P<0.05
n=72

Why the study?

The sensitivity and specificity of the echocardiographic Myocardial Performance Index (MPI) for assessing acute right ventricular infarction in patients with acute inferior myocardial infarction needed to be determined.

Key Points

To determine the sensitivity and specificity of the right ventricular myocardial performance index (MPI) for assessing acute right ventricular myocardial infarction in patients with acute inferior myocardial infarction.
Descriptive cross-sectional study of 72 patients admitted to a coronary care unit with acute inferior myocardial infarction (IMI), evaluated by echocardiography within 24 hours of admission.
Patients were categorized into Group I (24 patients with acute inferior MI and right ventricular involvement diagnosed by ≥1 mm ST-segment elevation in leads V3R-V5R) and Group II (48 patients with isolated acute inferior MI).
Serial echocardiographic follow-up was performed after 5 days in 21 Group I patients and 8 Group II patients who presented with an initial right ventricular MPI >0.30.
Initial right ventricular MPI was significantly higher in Group I patients than in Group II patients (0.57 ± 0.13 vs. 0.24 ± 0.12, p < .05).
An RV MPI cutoff ≥ 0.30 demonstrated 100% sensitivity, 83.33% specificity (reported as 89% in the abstract), 88.89% diagnostic accuracy, 75% positive predictive value, and 100% negative predictive value for identifying right ventricular infarction.
Repeat assessment at 5 days revealed significant reductions in RV MPI to 0.19 ± 0.07 in Group I (difference -0.38 ± 0.12, p < .05) and to 0.22 ± 0.09 in Group II patients with baseline MPI ≥ 0.30 (difference -0.23 ± 0.9, p < .05).

Study Design

Type

Cross-Sectional (n=72)

Blinding

Single-blind

Multicenter

No

PICO

P

Population

72 patients (mean age ~50 years, 16.7% female) admitted with acute inferior wall myocardial infarction within 12 hours of chest pain onset, free of prior MI or chronic pulmonary/valvular disease, evaluated within 24 hours and followed for 5 days.

E

Exposure / Comparator

Right Ventricular Myocardial Performance Index (RVMPI ≥ 0.30) vs Acute inferior myocardial infarction without right ventricular involvement on right-sided ECG

O

Primary Outcome

Right Ventricular Myocardial Performance Index (RVMPI) within 24 hours of admission and diagnostic performance (RVMPI ≥ 0.30) for acute right ventricular myocardial infarction — Sensitivity 100%, Specificity 83.33% (Accuracy 88.89%), p=<0.05

Main Result

Mean Difference: 0.33

Absolute Event Rate: 0.57% vs 0.24%

p-value: p=<0.05

Limitations

Relatively small sample size
Single-center study
Invasive hemodynamic assessment was not performed

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Answers are grounded in this paper and cite their sources.

Implication

RVMPI may aid acute RV infarction diagnosis; leaves open prospective validation before clinical adoption.

Abstract

The goal of this study was to determine the sensitivity and specificity of the Myocardial Performance Index (MPI)for the assessment of acute right ventricular Infraction. This was a descriptive type of cross-sectional study. The study was carried out in the Coronary Care Unit, Department of Cardiology, Sir Salimulla Medical College, and Mitford Hospital. After exclusion total of 72 patients were included in this study, of which 24 had acute inferior MI with RV involvement diagnosed by ≥ 1mm ST-segment elevation in V3R-V5R of right-sided ECG (group-I) and 48 had acute inferior MI without RV involvement (group-II). All patients underwent echocardiography within 24 hours of admission. The study revealed that RV MPI was significantly increased (0.57± 0.13) in RVMI patients compared to IMI without RVMI (0.24± 0.12). MPI detected RVMI in 08 patients (0.45± 0.09) who did not have ECG findings of RVMI (Group-II). Repeat MPI estimation after 05 days in 21 RVMI (Group-I) and 08 isolated IMI (Group-II) patients who had RVMPI > 0.30showed dramatic reduction of MPI (0.19± 0.07 and 0.22±0.09), respectively. RV MPI ≥ 0.30 has high sensitivity (100%) and specificity (89%) for the diagnosis of RVMI in the presence of acute IMI. The study recommended that MPI may be a new non-invasive echocardiographic gold standard tool in diagnosing acute RVMI and also assessment of right ventricular function in acute inferior myocardial infarction with high sensitivity and specificity. MPI changes can be serially followed in acute RVMI patients to assess changes in RV function. TAJ 2022; 35: No-1: 17-24

Discussion

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Cite This Study

Karim et al. (2022) conducted a cross-sectional in Acute inferior wall myocardial infarction (with or without right ventricular infarction) (n=72). Right Ventricular Myocardial Performance Index (RVMPI ≥ 0.30) vs. Acute inferior myocardial infarction without right ventricular involvement on right-sided ECG was evaluated on Right Ventricular Myocardial Performance Index (RVMPI) within 24 hours of admission and diagnostic performance (RVMPI ≥ 0.30) for acute right ventricular myocardial infarction (Sensitivity 100%, Specificity 83.33% (Accuracy 88.89%), p=<0.05). Right ventricular myocardial performance index (RVMPI ≥ 0.30) diagnosed acute right ventricular infarction with 100% sensitivity and 83.33%-89% specificity (mean 0.57 vs 0.24, p<0.05).

synapsesocial.com/papers/6aeb2c519355ebe6ad2e24cb https://doi.org/10.3329/taj.v35i1.61135

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Sensitivity and Specificity of Myocardial Performance Indexing Assessing Acute Right Ventricular Infarction

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Sensitivity and Specificity of Myocardial Performance Indexing Assessing Acute Right Ventricular Infarction

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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