Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis

Rajesh, Gopalan Nair; Raju, Deepak; Nandan, Deepak; Vellani, Haridasan; Vinayakumar, Desabandhu; Muneer, Kader; Sajeev, C.G.; Babu, K Jagadeesh; Krishnan, M.N.

doi:10.1016/j.ihj.2013.08.021

Cited by 22 publications

(27 citation statements)

References 35 publications

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“…The present study showed no statistically significant difference between groups regarding demographic data and risk factors, in concordance with the studies of Rajesh et al, El Sebaie et al, and Shetaya et al…”

Section: Discussionsupporting

confidence: 93%

“…There were no significant differences in LVEF and time to echocardiography between groups, in agreement with El Sebaie et al and Shetaya et al But the study by Rajesh et al showed that LVEF was significantly lower in the group with proximal RCA lesion …”

Section: Discussionsupporting

confidence: 86%

“…We found that time from symptoms to ECG was significantly longer in group 1, in disconcordance with Rajesh et al This may be due to differences in the study design. These ECG clues for RV MI diagnosis are often missed as the ECG changes disappear soon or the patients present late.…”

Section: Discussioncontrasting

confidence: 51%

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High‐risk inferior myocardial infarction: Can speckle tracking predict proximal right coronary lesions?

Roshdy

El-Dosouky

Soliman

2018

Clinical Cardiology

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Background It is important to diagnose right ventricular (RV) infarction in the setting of acute inferior myocardial infarction (MI). We aimed to improve the diagnostic accuracy of RV infarction and identify a high‐risk subset of inferior MI patients with proximal RCA lesions. Hypothesis We tried to find the link between speckle tracking and coronaries in high risk inferior infarction Methods This study included 68 patients within 24 hours of first acute inferior MI. Group 1 (n = 49) isolated inferior MI; group 2 (n = 19) inferior and RV MI. echocardiography for RV free wall longitudinal strain (FWLS), RV fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (MPI) and peak systolic velocity (S′). Results Group 2 had higher MPI by tissue Doppler and 2D‐RV average FWLS, whereas RV FAC, S′, and TAPSE were lower (P < 0.001). In group 1, 14.4% had a significant proximal RCA lesion with impaired RV function. RV average FWLS at a cutoff value ≥ − 19.7% can predict proximal RCA culprit lesion with 91.7% sensitivity and 70.5% specificity, which was detected as an independent predictor in multivariate logistic regression (odds ratio: 37.75, P = 0.036). Conclusions 2D RV average FWLS at a cutoff of ≥ − 19.7% is a useful added tool for diagnosis of RV involvement and an independent predictor to rule in proximal RCA culprit lesion in inferior‐wall MI patients in the emergency department.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 86%

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High‐risk inferior myocardial infarction: Can speckle tracking predict proximal right coronary lesions?

Roshdy

El-Dosouky

Soliman

2018

Clinical Cardiology

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“…RV Tei index in patients with proximal RCA lesion and RV-MI also increased as compared to those with non-proximal RCA lesion (0.65 ± 0.19 vs. 0.40 ± 0.15; p< 0.01) [31].…”

Section: Discussionmentioning

confidence: 75%

Accuracy of Clinical Symptoms, Electrocardiographic and Echocardiographic Parameters for Diagnosis of Significant Proximal Right Coronary Artery Lesion in Acute Inferior Wall Myocardial Infarction

Shetaya

Elkhashab

Razek

2016

ICFJ

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IntroductionRight ventricular (RV) infarction is one of the major causes of RV contractile dysfunction. RV involvement occurs in 20-50% of inferior infarctions [1]. Patients with RV infarction associated with inferior infarction have much higher rates of significant hypotension, bradycardia requiring pacing, and in-hospital mortality compared to isolated inferior infarction [2] Occlusion of proximal dominant RCA is usually responsible for RV infarction in inferior wall myocardial infarction [3] Results: There were 35 patients with first episode of IWMI, group A (n =14 patients) and group B (n =21patients), There were significant differences between groups in TAPSE (1.28cm vs 1.98 p < 0.001), MPI-TDI (0.69±0.12 vs 0.38±0.05 p < 0.001), and in S'velocity from RV free wall ( 0.09m/s±0.02 vs 0.12m/s ±0.02 p < 0.001). It was found that S'<10cm/s is a predictor of proximal RCA lesion with sensitivity of 92.86% and specificity of 85.71%, ppv 81.25, npv 94.74. MPI-TDI>0.55 had a sensitivity of 92.86 % and a specificity of 100%, 100% PPV and 95.45% NPV. TAPSE<16mm had a sensitivity of 93%, and a specificity of 100%. Conclusion: RV indices (S' velocity, MPI-TDI and TAPSE ) are useful in predicting proximal RCA as infarct related artery in IWMI.

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“…29 Compared to other echocardiographic parameters such as myocardial performance index, fractional area change and so on, TAPSE has higher reproducibility. 30, 31 Furthermore, measurement of this is very simple and practical with any echo machine. In contrast, RVWD was devised by us, and its advantage has not been studied sufficiently.…”

Section: Discussionmentioning

confidence: 99%

Alternation of Right Ventricular Contraction Pattern in Healthy Children

Hashimoto

Watanabe

2014

Circ J

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Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis

Abstract: RV function indices like TAPSE, MPI-TDI and S' velocity are useful in predicting proximal RCA stenosis in first episode of acute IWMI.

Cited by 22 publications

References 35 publications

High‐risk inferior myocardial infarction: Can speckle tracking predict proximal right coronary lesions?

High‐risk inferior myocardial infarction: Can speckle tracking predict proximal right coronary lesions?

Accuracy of Clinical Symptoms, Electrocardiographic and Echocardiographic Parameters for Diagnosis of Significant Proximal Right Coronary Artery Lesion in Acute Inferior Wall Myocardial Infarction

Alternation of Right Ventricular Contraction Pattern in Healthy Children

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