Right Ventricular Functional Assessment in Acute Myocardial Infarction Using Strain Imaging Parameters and Its Angiographic Correlation
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 1
Abstract
Introduction: Echocardiographic right ventricle (RV) functional parameters have independent and additive prognostic value in patients with left ventricle (LV) dysfunction following acute myocardial infarction (AMI) strain echocardiography is known to be a reliable method for the quantification of regional contractile dysfunction with the ability to detect subclinical cardiac dysfunction, and it is a feasible tool to evaluate RV global and regional myocardial function. It can measure RV systolic function in a non geometric manner like its evaluation of LV systolic function. Strain imaging has been proposed as an objective and quantitative measurement of wall motion abnormalities. The Aim of Our Study: To correlate RV strain parameters with clinical, echocardiographic, and angiographic parameters. Materials and Methods: Echocardiography was performed immediately after thrombolysis in patients with AMI using GE VIVID T8 machine, 3 Sc-Rs transducer adult probe equipped with tissue Doppler and speckle-tracking technology. RV strain assessment was done by speckle-tracking method. Coronary angiogram was performed in all patients included in the study. Results: A total of 102 consecutive patients admitted in our Integrated Critical Care Unit with the first episode of AMI were included in our study. Among 102 patients, 80 (78%) were male and 22 (22%) were female. Anterior wall MI (AWMI) was more common (58%), inferior wall MI (IWMI) (40%), left ventricular mass index (LWMI) (2%). 40 patients out of the total 102 patients had single-vessel disease, 36 patients had double-vessel disease, and 8 patients had triple-vessel disease. A total of 14 patients had left main coronary artery involvement along with other vessel disease. In the study population, AWMI group had a mean mitral E/e’ of 9.742 ± 3.421, IWMI group had a mean mitral E/e’ of 10.556 ± 2.593, and LWMI group had a mean mitral E/e’of 9.57 ± 0.707. AWMI group had a mean RV mid-velocity of 3.986 ± 0.933. IWMI group had a mean RV mid-velocity of 3.385 ± 0.465. LWMI group has mean RV mid-velocity of 5.15 ± 1.626. AWMI group had a global RV mean velocity of 4.231 ± 1.281. IWMI group had a global RV mean velocity of 3.712 ± 0.591. LWMI group had a global RV mean velocity of 5.2 ± 0.849. Conclusion: Patients with IWMI had much lower segmental and global longitudinal strain RV values compared to AMWI patients and the difference was statistically significant. RV dysfunction has also been related to poor prognosis; therefore, the function of both ventricles after AMI should be considered. Quantitative assessment of RV function with RV strain may improve the risk stratification of patients after AMI.
Authors and Affiliations
Naina Mohamed S, Sathish Kumar Subbaraj, Balasubramaniyan S, Veeramani S. R, Sivakumar G. S, Selvarani G, Hemanath T. R, Ramesh R
Keywords
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