Usefulness of Pulmonary Regurgitation Doppler Tracings in Predicting Outcome in Patients with Acute Inferior Wall Myocardial Infarction
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 5
Abstract
Background: Pulmonary regurgitation (PR) flow-derived Doppler curve is useful in recognizing RV involvement during the first 24 hours of AMI. A PR Doppler pattern depends mainly on the diastolic RV pressure pattern, which is altered during AMI. So modification of RV pressure modifies the regurgitant flow pattern. Aim of the Study: To evaluate the doppler predictors of PR and to assess its prognostic implications in acute MI patients. Materials and Methods: This is a prospective study conducted in ICCU of Rajiv Gandhi government hospital. Detailed history, physical examination, ECG and two dimensional and Doppler echo and coronary angiography was done for all patients. The prognostic implication of RV involvement was derived by electrocardiographic and echocardiographic criteria. Results: Out of 94 patients, “Group 1” had 53 patients with PHT ≤ 150 ms & Group 2 had 41 patients with PHT > 150 ms. Statistically significant difference seen in RV dimension, RV/LV ratio, RV FAC, RV ejection fraction, TAPSE, MASV and RV Tei index. Peak PR velocity and end diastolic velocity does not vary between both groups significantly. Mid diastolic minimum velocity has a mean of 0.33 m/sec in Group 1 and 0.69 m/sec in Group2 (p 65 years (p = 0.049), ST elevation in V4R (P = 0.011), RV dilatation in echocardiography (p = 0.018), Doppler criteria indicating RV involvement such as PR pressure half time ≤ 150 msec (0.018) and combined Vmin / Vmax ≤ 0.5 and PR PHT ≤ 150 msec (P = 0.042). The in-hospital events are also associated significantly with the presence of triple vessel disease in coronary angiogram. Conclusion: In patients with acute IWMI, flow Doppler tracings of PR are useful in the prediction of in-hospital complications. PR derived parameters (PHT of PR ≤ 150 ms and Vmin /Vmax ≤ 0.5) are the excellent predictors of overall in-hospital complications.
Authors and Affiliations
T R Hemanath, G Selvarani, G S Sivakumar, R Ramesh, S Sathish Kumar
Keywords
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