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Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis.
Indian Heart J. 2013 Sep-Oct; 65(5):522-8.IH

Abstract

BACKGROUND

Presence of right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we attempted to correlate various indices of RV function assessed by echocardiography with presence of a proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI.

METHODS

In a prospective study, patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and indices of RV function viz. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients who underwent coronary angiogram (CAG) within one month and they were classified into group 1 and group 2 based on the presence or absence, respectively, of a significant proximal RCA stenosis.

RESULTS

There were 90 patients with first episode of IWMI of which 67 patients underwent CAG. There was significant difference between group 1 (n = 26) and group 2 (n = 41) in TAPSE (13.5 ± 1.3 vs 21.3 ± 1.7, p < 0.001), MPI by tissue Doppler (0.87 ± 0.1 vs 0.55 ± 0.2, p < 0.001) and in tissue Doppler systolic velocity from RV free wall (S' 9.8 ± 1.1 vs 15.0 ± 1.5, p < 0.001). There was a good interobserver correlation for TAPSE, MPI by TDI, and S' velocity. TAPSE ≤ 16 (sensitivity 93%, specificity 100%), MPI-TDI ≥ 0.69 (sensitivity 94.7%, specificity 93.5%), S ≤ 12.3 (sensitivity 90.3%, specificity 94.3%) were useful in predicting presence of proximal RCA stenosis.

CONCLUSION

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

Authors+Show Affiliations

Department of Cardiology, Govt. Medical College, Kozhikode 673017, Kerala, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24206875

Citation

Rajesh, Gopalan Nair, et al. "Echocardiographic Assessment of Right Ventricular Function in Inferior Wall Myocardial Infarction and Angiographic Correlation to Proximal Right Coronary Artery Stenosis." Indian Heart Journal, vol. 65, no. 5, 2013, pp. 522-8.
Rajesh GN, Raju D, Nandan D, et al. Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis. Indian Heart J. 2013;65(5):522-8.
Rajesh, G. N., Raju, D., Nandan, D., Haridasan, V., Vinayakumar, D., Muneer, K., Sajeev, C. G., Babu, K., & Krishnan, M. N. (2013). Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis. Indian Heart Journal, 65(5), 522-8. https://doi.org/10.1016/j.ihj.2013.08.021
Rajesh GN, et al. Echocardiographic Assessment of Right Ventricular Function in Inferior Wall Myocardial Infarction and Angiographic Correlation to Proximal Right Coronary Artery Stenosis. Indian Heart J. 2013 Sep-Oct;65(5):522-8. PubMed PMID: 24206875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis. AU - Rajesh,Gopalan Nair, AU - Raju,Deepak, AU - Nandan,Deepak, AU - Haridasan,Vellani, AU - Vinayakumar,Desabandhu, AU - Muneer,Kader, AU - Sajeev,C G, AU - Babu,Kadangot, AU - Krishnan,M N, Y1 - 2013/09/14/ PY - 2012/10/21/received PY - 2013/05/01/revised PY - 2013/08/09/accepted PY - 2013/11/12/entrez PY - 2013/11/12/pubmed PY - 2015/11/6/medline KW - A' KW - Am KW - BMI KW - CAG KW - E' KW - ET KW - Em KW - HTN KW - ICT KW - IRT KW - IWMI KW - LV ejection fraction KW - LVEF KW - MPI KW - MPI-PW KW - MPI-TDI KW - PCI KW - RCA KW - RV KW - RV WMA KW - RVFAC KW - Right coronary artery stenosis KW - Right ventricular function KW - Right ventricular infarction KW - S' KW - TAPSE KW - body mass index KW - coronary angiogram KW - ejection time KW - hypertension KW - inferior wall myocardial infarction KW - isovolumic contraction time KW - isovolumic relaxation time KW - mitral early diastolic velocity KW - mitral late diastolic velocity KW - myocardial performance index KW - myocardial performance index by pulsed wave Doppler KW - myocardial performance index by tissue Doppler KW - percutaneous coronary intervention KW - right coronary artery KW - right ventricle KW - right ventricular fractional area change KW - right ventricular wall motion abnormalities KW - tissue Doppler early diastolic velocity KW - tissue Doppler late diastolic velocity KW - tissue Doppler systolic velocity KW - tricuspid annular plane systolic excursion SP - 522 EP - 8 JF - Indian heart journal JO - Indian Heart J VL - 65 IS - 5 N2 - BACKGROUND: Presence of right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we attempted to correlate various indices of RV function assessed by echocardiography with presence of a proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI. METHODS: In a prospective study, patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and indices of RV function viz. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients who underwent coronary angiogram (CAG) within one month and they were classified into group 1 and group 2 based on the presence or absence, respectively, of a significant proximal RCA stenosis. RESULTS: There were 90 patients with first episode of IWMI of which 67 patients underwent CAG. There was significant difference between group 1 (n = 26) and group 2 (n = 41) in TAPSE (13.5 ± 1.3 vs 21.3 ± 1.7, p < 0.001), MPI by tissue Doppler (0.87 ± 0.1 vs 0.55 ± 0.2, p < 0.001) and in tissue Doppler systolic velocity from RV free wall (S' 9.8 ± 1.1 vs 15.0 ± 1.5, p < 0.001). There was a good interobserver correlation for TAPSE, MPI by TDI, and S' velocity. TAPSE ≤ 16 (sensitivity 93%, specificity 100%), MPI-TDI ≥ 0.69 (sensitivity 94.7%, specificity 93.5%), S ≤ 12.3 (sensitivity 90.3%, specificity 94.3%) were useful in predicting presence of proximal RCA stenosis. CONCLUSION: RV function indices like TAPSE, MPI-TDI and S' velocity are useful in predicting proximal RCA stenosis in first episode of acute IWMI. SN - 2213-3763 UR - https://www.unboundmedicine.com/medline/citation/24206875/Echocardiographic_assessment_of_right_ventricular_function_in_inferior_wall_myocardial_infarction_and_angiographic_correlation_to_proximal_right_coronary_artery_stenosis_ DB - PRIME DP - Unbound Medicine ER -