Assessment of right ventricular function after successful revascularization for acute anterior myocardial infarction without right ventricular infarction by echocardiography

Abstract

Background Right ventricular (RV) involvement in acute left ventricular (LV) myocardial infarction (MI) is frequently underestimated in the clinical setting owing to the diagnostic limitations of the electrocardiogram and echocardiography. Objective To assess RV function in patients presented with first acute anterior ST elevation myocardial infarction (STEMI) who underwent successful primary percutaneous coronary intervention (PCI) and factors affecting it. Methods Forty consecutive patients with anterior STEMI who underwent successful primary PCI were enrolled in the study. Presence of a coexisting clinical condition that might affect RV function, patients with RV infarction or those having significant stenosis (>50%) affecting RV branch or right coronary artery proximal to RV branch were excluded. Echocardiography was performed during the hospital stay to assess the LV and RV systolic and diastolic function with special focus on tricuspid annular plane systolic excursion, RV end-diastolic dimension, right atrial area, RV fractional area change, and tissue Doppler-derived myocardial performance index. Results and Conclusion RV dysfunction according to our definition in the first anterior MI occurred in (55%) of the study population. Independent predictors for abnormal RV function were left circumflex artery mid or proximal affection, eventful procedure, occurrence of no reflow, glucose level, LV end-systolic dimension, LV end-diastolic dimension, and LV ejection fraction.

Echocardiographic Assessment of Right Ventricular Function in Patients with Acute Anterior wall Myocardial Infarction

“…In contrast to other research, Abdeltawab et al (14) attributed this to patients who were on average 45.9+7.6 years younger, which is why when comparing both groups' normal and poor RV performance, the influence of age becomes apparent in comparison with their population. Regarding sex or DM, HTN, or hyperlipidemia, there was no statistically significant difference between the groups.…”

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

“…They, however, failed to define the time of echocardiography after ASTEMI, and they used an echocardiography modality that was not only dependent on the ultrasound beam angle but also associated with low spatial resolution, high noise, and interobserver variability [ 27 ]. Still, it seems that echocardiography was not capable of detecting this damage to the RV in all patients with ASTEMI [ 28 , 29 ]. Similar to Nourian et al, we found that RA reservoir and conduit functions were impaired in patients with ASTEMI, while we detected no significant impairment in RV function in the same phase.…”

Correlation between Right Ventricular Function with Revascularization Time and 30-day Mortality in ST-Elevation Myocardial Infarction Patients Underwent Right Coronary Artery Intervention

“…Reliable data on RV damage using cardiac magnetic resonance imaging (MRI) are scarce. 12 The association between right ventricular functional parameters and STEMI [12][13][14][15][16] was previously examined. Morbidity and mortality are well known to be associated with right ventricular (RV) involvement after an acute myocardial infarction (MI).…”