Speckle tracking versus tissue Doppler assessment of Right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN MEDICAL SCIENCES - Year 2017, Vol 3, Issue 5
Abstract
Right ventricular (RV) function, has not been widely studied after acute myocardial infarction (MI). The current study describes the use of recent modalities of echocardiography (Echo) to provide a simple accurate diagnosis of ventricular functions post acute inferior MI. Aims of the study: The assessment of the RV functions in acute inferior wall MI using ventricular strain assessed by 2D longitudinal speckle tracking in comparison to tissue Doppler imaging (TDI) as well as correlation of the results of RV function with the angiographic data of right coronary artery (RCA) stenosis in the first episode of acute inferior wall MI. Patients & methods. In The patient group composed of 45 patients with first episode of acute inferior MI, twenty patients were selected for the control group. All 65 patients underwent echo assessment indices of dimensions, ventricular function (EF, FS and TAPSE), ventricular myocardial velocities by TDI and global longitudinal strain of both ventricle by speckle tracking. Patients were then divided into two groups A and B according to the presence or absence of significant proximal RCA stenosis. Results: The study included 45 patients with first episode of IWMI underwent coronary angiography (group2) and 20 persons as control (group1). TAPSE, TDI derived systolic and early diastolic velocities as well as global longitudinal strain assessed by 2D- speckle tracking all were significantly reduced in patients versus control group. On the other hand, patients with proximal RCA stenosis (group A, 17 patients) compared to non-proximal RCA lesions(group B,28 patients) had significantly lower EF, FS, TAPSE, impaired both systolic and diastolic function of RV including TDI derived velocities and global longitudinal strain which assessed by 2D- speckle tracking. Conclusion: RV functions may be globally significantly reduced in those with first attack of inferior wall MI particularly those with proximal RCA lesions detected by recent modalities of echo even in those with apparently normal traditional echo parameters.
Authors and Affiliations
Mohamed Mahmoud ⃰, Mohamed Salah A. Elsalam⃰⃰ , ⃰ , Hatem A. elrahman ⃰⃰⃰ and Tarek A.M. Khalifa ⃰⃰⃰⃰
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