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

Abstract

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.

Age- and gender-related normal references of right ventricular strain values by tissue tracking cardiac magnetic resonance: results from a Chinese population

“…Tissue tagging, a CMR technique that prescribes multiple grids on the myocardial tissue to track deformation throughout the cardiac cycle, is typically regarded as the golden standard for LV deformation (14). Echocardiographic deformation imaging using either speckle tracking or tissue Doppler imaging has also gained popularity for those patients unfit to undergo CMR examinations (12,15). Of note, these techniques are technically demanding, time-consuming, and have primarily been validated for use in the LV, but render themselves less suitable for the thin-walled and highly trabeculated RV (11,(16)(17)(18)(19)(20).…”

Evaluation of Variable Parameter Active Demons Algorithm-Based Diffusion Tensor Imaging on Ventricular Remodeling after Myocardial Infarction and Nursing

“…In the actual deformation iteration, the deformation field will remain continuous in the image. To make the algorithm be continuous in the global scope, Gaussian filter [11] is introduced to smooth the deformation field, and then the deformation vector is as follows:…”

Prognostic Significance of Right Ventricular Global Longitudinal Strain in Acute Myocardial Infarction and Angiographic Correlation

“…22 In patients with ischemic cardiomyopathy lower RVGLS (≥ −15.4%) was associated with lower one-year event-free survival (93.0% vs. 67.2%, p = 0.030). 23 From various studies conducted in patients presenting with inferior wall myocardial infarction, impaired RVGLS(≥−19.7% ) have been found to be predictive of proximal RCA culprit lesions 24 , complications like atrioventricular blocks , cardiogenic shock (RVGLS >-15.9%) 25 , (RVGLS ≥ −15.5%) was associated with signi cantly lower rates of survival and event-free survival 5 Among patients presenting with inferior wall infarction and treated with primary angioplasty, RVGLS was superior to the conventional echocardiographic parameters in predicting recovery and late remodelling of the right ventricle that is associated with the occurrence of future cardiovascular events like recurrent heart failure, recurrent infarction due to stent thrombosis . 26 In patients presenting with NSTEMI, RVGLS was signi cantly associated with poor cardiovascular outcomes and hemodynamically signi cant arrhythmias 27 Abnormally low RV GLS may represent a dysynchrony in the right ventricle resulting in mechanical and electrical heterogeneity setting a milieu for development for recurrent arrhythmias and heart failure 28 .…”