Assessment of right ventricular function in acute inferior wall myocardial infarction in patients treated with primary percutaneous coronary intervention

Abstract

Background and Objective: Since there is a difficulty in the assessment of RV function by 2D echocardiography, a noninvasive, practical, bedside and cost effective method is desirable. Tissue doppler technique enables to visualize systolic and diastolic velocities of the tissue through sample volume replacement. The aim of the study is to evaluate right ventricular function using tissue doppler study in patients with inferior myocardial infarction treated with primary PCI. Methodology: Patients with first, acute, inferior STEMI treated with PPCI were prospectively assessed. The RVMI was defined as an ST-segment elevation ≥0.1 mV in lead V4R. Echocardiography with TDI was performed after PPCI within 24-48 h of the onset of symptoms. Follow up including in-hospital events was performed. Results: Receiver Operating Characteristics (ROC) revealed high diagnostic significance of MPI (Area under the curve was 0.91) with a cut off value >0.51 for a diagnosis of RVMI had a 83.3% sensitivity and a 80% specificity and for SmRV area under the curve was 0.90 with cut off value was (13.5 cm sec-1) with sensitivity 83.3% and specificity 70%. In multivariate stepwise logestic analysis, peak systolic RV velocity (SmRV) with odd’s ratio (OR = 0.419) was independent predictors of in-hospital prognosis. Conclusion: Tissue Doppler Imaging (TDI) is a relatively new echocardiographic technique that uses doppler principles to measure the velocity of myocardial motion. It has been found a high diagnostic significance of myocardial performance index MPI and systolic myocardial velocity (Sm) in predicting RVMI in inferior MI patients.