Evaluation of the right atrial phasic functions in patients with anterior ST-elevation myocardial infarction: a 2D speckle-tracking echocardiography study

Abstract

Background Evidence suggests that changes in left ventricular systolic and diastolic functions may affect right atrial (RA) phasic functions. We aimed to evaluate RA phasic functions in the presence of anterior ST-elevation myocardial infarction (ASTEMI) as an acute event and to compare the findings with those in a control group. Methods We recruited 92 consecutive ASTEMI patients without accompanying significant stenosis in the proximal and middle parts of the right coronary artery and 31 control subjects, matched for age, sex, diabetes, and hypertension. RA phasic functions were evaluated concerning their longitudinal 2D speckle-tracking echocardiography-derived markers. The ASTEMI group was followed up for all-cause mortality or reinfarction. Results In the ASTEMI group, RA strain was reduced during the reservoir (33.2% ± 4.3% vs 30.5% ± 8.1%; P = 0.021) and conduit (16% [12–18%] vs 14% [9–17%]; P = 0.048) phases. The other longitudinal 2D speckle-tracking echocardiography-derived markers of RA phasic functions were not different between the 2 groups. RA strain and strain rate during the contraction phase were predictive of all-cause mortality or reinfarction (hazard ratio = 0.80; P = 0.024 and hazard ratio = 0.39; P = 0.026, respectively). Conclusions Based on 2D speckle-tracking echocardiography, in the ASTEMI group, compared with the control group, RA reservoir and conduit functions were reduced, while RA contraction function was preserved. RA contraction function was predictive of all-cause mortality or reinfarction during the follow-up period.

Value of 2D speckle tracking technique combined with real-time 3-dimensional echocardiography in the evaluation of the right atrial function in patients with 3-branch coronary artery disease without myocardial infarction

“…[15] Right atrial volume and function have been identified as important prognostic indicators for a variety of cardiovascular diseases [16,17] and as independent predictors of outcomes in many older patients susceptible to heart disease. [18,19] The right atrium has long been a neglected chamber. However, it is the hub through which blood from the entire body flows into the heart, and its chronotropic function plays 3 important roles throughout the cardiac cycle [20,21] : Storage function: the tricuspid valve closes during the right ventricular is an important cardiac chamber that regulates ventricular filling.…”

“…[ 15 ] Right atrial volume and function have been identified as important prognostic indicators for a variety of cardiovascular diseases [ 16 , 17 ] and as independent predictors of outcomes in many older patients susceptible to heart disease. [ 18 , 19 ]…”

Evaluation of right atrial function by two-dimensional echocardiography and strain imaging in patients with RCA CTO recanalization

“…Eisvand et al also found decreased right atrial function in patients with acute anterior myocardial infarction. In this collective RA contraction function was predictive of all-cause mortality or reinfarction during the follow-up period [ 25 ]. In a collective of 1235 patients with acute myocardial infarction (NSTEMI/STEMI) who underwent cardiac magnetic resonance imaging after successful PCI Schuster et al found that the RA reservoir and the RA conduit function was impaired and predictive for onset of heart failure and MACE [ 12 ].…”