Abstract
Right ventricular (RV) involvement increases mortality and morbidity in inferior myocardial infarction (MI). There are sparse data on the usefulness of pulsed tissue Doppler imaging (TDI) in the diagnosis of RV dysfunction in ST segment elevation MI (STEMI). This study evaluate the diagnostic and prognostic significance of RV systolic and diastolic function compared to classical electrocardiographic RVMI diagnostic criteria in this group of patients. Consecutive patients with first, acute, inferior STEMI were prospectively assessed. The RVMI was defined as an ST-segment elevation ≥ 0.1 mV in lead V4R. Echocardiography with TDI was performed within24 h of the onset of symptoms. Out of 31 patients (mean age 56.39 ± 9.02 years), RVMI was found in 18 (37%). Multivariate analysis showed that two variables—RV systolic and diastolic function, were independent predictors of in-hospital prognosis. Sensitivity and specificity the RV systolic function were 94,4% and 69,2%, respectively. While RV diastolic function were 44% and 76,9%, respectively. RV systolic function predict ECG diagnosis of RVMI with relatively high sensitivity and specificity. RV diastolic function predict ECG diagnosis of RVMI with relatively low sensitivity but with high specificity.Keywords: tissue Doppler imaging, RV myocardial infarction, inferior myocardial infarction
Highlights
Right ventricular (RV) myocardial infarction (MI) occurs in 30–50% of patients with inferior MI (Goldstein, 2002)
The RVMI leads to RV dysfunction that increases early mortality and morbidity independently of the degree of left ventricular dysfunction (Kukla et al, 2006)
Previous study are available on the usefulness of pulsed wave tissue Doppler imaging (TDI) in the diagnosis of RVMI in patients with inferior MI, but there are sparse and conflicting data on the usefulness of RV myocardial velocities derived from TDI in this group of patients (Hsiao et al, 2010)
Summary
Right ventricular (RV) myocardial infarction (MI) occurs in 30–50% of patients with inferior MI (Goldstein, 2002). It is caused mainly by proximal right coronary artery (RCA) lesion (Bowers et al, 2002). Previous study are available on the usefulness of pulsed wave TDI in the diagnosis of RVMI in patients with inferior MI, but there are sparse and conflicting data on the usefulness of RV myocardial velocities derived from TDI in this group of patients (Hsiao et al, 2010). The aim of this study was to evaluate the diagnostic and prognostic significance of RV systolic and diastolic function compared to classical electrocardiographic RVMI diagnostic criteria in this group of patients
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