Assessment of the right ventricular systolic function after acute right ventricular myocardial infarction in association with left ventricular inferior myocardial infarction by two-dimensional speckle tracking echocardiography

Abstract

Objective To assess right ventricular (RV) systolic function in patients with acute right ventricular myocardial infarction (RVMI) in association with left ventricular inferior myocardial infarction (INFMI) by applying 2-dimensional (2D) speckle tracking imaging (STI) longitudinal strain (LS) and strain rate (LSr) parameters. Methods Seventeen consecutive patients diagnosed with INFMI in association with RVMI were included in our study, 21 INFMI patients without RVMI were also included to match the RVMI group. RVMI group and INFMI group were called acute myocardial infarction (AMI) group, all of them were diagnosed AMI the first time. Twenty-four chest pain patients admitted consecutively at the same time but with negative results in the selective coronary angiography were served as blank control. Echocardiography were performed within 48 hours. The RVLS parameters, which include LS and LSr, were then analyzed offline. Results The RV global LS (RVGLS), the LS of the basal and mid segments of the free wall and septum, the LSr of the basal and mid segments of the free wall were lower than control group in the AMI group (P<0.05). Compared to INFMI group, the RVGLS, the LS of the mid and apical segments of the free wall and the LSr of the mid segments of the septum were lower in the RVMI group (P<0.05). In the single parameter mode of ROC curve analysis, the diagnosis efficiency of RV free wall LS (RVFWLS) and RVGLS were higher than other parameters. The cut-off value of RVFWLS and RVGLS were -18.26% and -16.27% respectively (sensitivity were 100% and 100%, respectively, specificity were 65.5% and 72.4%, respectively). Conclusions The 2D-STI RVLS parameters precisely reflect the impaired RV systolic function in the INFMI and RVMI patients, the RV global systolic function are even worse when RVMI involved, mainly for the RV free wall. RVLS parameters are good predictors of RVMI which could provide more references for the early diagnosis and functional evaluation of RV in acute INFMI patients with RVMI. Key words: Echocardiography; Myocardial infarction; Ventricular function, right; Speckle tracking imaging