Echocardiographic Assessment of Right Ventricular Function in Inferior Wall Myocardial Infarction and Angiographic Correlation to Proximal Right Coronary Artery Stenosis

Overview

Journal Indian Heart J

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2013 Nov 12

PMID 24206875

Citations 8

Authors

Gopalan Nair Rajesh

Deepak Raju

Deepak Nandan

Vellani Haridasan

Desabandhu Vinayakumar

Kader Muneer

C G Sajeev

Kadangot Babu

M N Krishnan

Affiliations

Soon will be listed here.

Abstract

Background: Presence of right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we attempted to correlate various indices of RV function assessed by echocardiography with presence of a proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI.

Methods: In a prospective study, patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and indices of RV function viz. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients who underwent coronary angiogram (CAG) within one month and they were classified into group 1 and group 2 based on the presence or absence, respectively, of a significant proximal RCA stenosis.

Results: There were 90 patients with first episode of IWMI of which 67 patients underwent CAG. There was significant difference between group 1 (n = 26) and group 2 (n = 41) in TAPSE (13.5 ± 1.3 vs 21.3 ± 1.7, p < 0.001), MPI by tissue Doppler (0.87 ± 0.1 vs 0.55 ± 0.2, p < 0.001) and in tissue Doppler systolic velocity from RV free wall (S' 9.8 ± 1.1 vs 15.0 ± 1.5, p < 0.001). There was a good interobserver correlation for TAPSE, MPI by TDI, and S' velocity. TAPSE ≤ 16 (sensitivity 93%, specificity 100%), MPI-TDI ≥ 0.69 (sensitivity 94.7%, specificity 93.5%), S ≤ 12.3 (sensitivity 90.3%, specificity 94.3%) were useful in predicting presence of proximal RCA stenosis.

Conclusion: RV function indices like TAPSE, MPI-TDI and S' velocity are useful in predicting proximal RCA stenosis in first episode of acute IWMI.

Citing Articles

Echocardiographic and Angiographic Assessment of Right Ventricular Function and Right Coronary Artery Stenosis in Acute Inferior Wall Myocardial Infarction.

Kumar R, Kumar P, Srivastava P, Kumar P Cureus. 2023; 15(10):e46403.

PMID: 37927618 PMC: 10620981. DOI: 10.7759/cureus.46403.

Role of 2-dimensional speckle tracking echocardiography in diagnosis of right ventricular involvement in patients with inferior wall myocardial infarction undergoing primary percutaneous coronary intervention.

Ahmed T, Abdel-Rahman E, Helmy H, Hasan-Ali H, El-Naggar H Int J Cardiovasc Imaging. 2021; 37(9):2625-2634.

PMID: 34156653 DOI: 10.1007/s10554-021-02311-2.

A comparison of artificial intelligence-based algorithms for the identification of patients with depressed right ventricular function from 2-dimentional echocardiography parameters and clinical features.

Ahmad A, Ibrahim Z, Sakr G, El-Bizri A, Masri L, Elhajj I Cardiovasc Diagn Ther. 2020; 10(4):859-868.

PMID: 32968641 PMC: 7487396. DOI: 10.21037/cdt-20-471.

The Role of Doppler Imaging in the Assessment of Right Ventricular Function: a Case-control Study of Acute Inferior Wall Infarction.

Dabirian M, Aarabi M, Nabati M, Bagheri B, Nikoohemat S, Mokhberi V Med Arch. 2018; 72(1):22-25.

PMID: 29416213 PMC: 5789569. DOI: 10.5455/medarh.2018.72.22-25.

High-risk inferior myocardial infarction: Can speckle tracking predict proximal right coronary lesions?.

Roshdy H, El-Dosouky I, Soliman M Clin Cardiol. 2018; 41(1):104-110.

PMID: 29377172 PMC: 6489836. DOI: 10.1002/clc.22859.

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