Echocardiographic assessment of right ventricular systolic function in acute inferior myocardial infarction

Abstract

Purpose . To assess the systolic function of the right ventricle in patients with acute inferior myocardial infarction after percutaneous coronary intervention according to the results of echocardiographic examination. Materials and methods . Echocardiographic data of 72 working-age patients with acute inferior myocardial infarction were analyzed. RV systolic function was assessed by TAPSE, S’TV, longitudinal strain of RV. Results . In 37.5% of patients with AMI of the inferior wall, in 96% of cases by ECG (elevation of the ST segment in the first hours of the disease) and in 4% by echocardiography (impaired local contractility after PCI), RV AMI was diagnosed. After PCI, the medians of TAPSE and S’TV obtained in M- and pulsed- wave modes of tissue Doppler between the groups with isolated AMI (n=45) and RV involvement (n=27) did not differ from the control. Analysis of all walls of the RV and three segments its free wall obtained by speckle tracking technology demonstrates large changes in the longitudinal deformity of the RV with a combination of AMI of both ventricles. The minimum longitudinal deformity in the groups with AMI, statistically significantly different from the control group, was observed at the basal level of the free wall of the RV and the interventricular septum. Changes in the parameters of deformity of the apical segment were present only in AMI of both ventricles. Conclusion . According to the results of echocardiographic examination in M-mode and pulsed-wave mode of tissue Doppler, the systolic function of the right ventricle in patients with acute inferior myocardial infarction both in combination with right ventricular infarction and in an isolated course a week after percutaneous coronary intervention corresponds to normal values. Using speckle tracking technology, the global longitudinal deformity of the right ventricle is not restored, remaining below the recommended norms and values of the control group in both AMI variants. The median of longitudinal deformity of the basal and median inferior septal segments had a minimum value (-9 and -12%) with combined lesions of both ventricles.