Right ventricular postsystolic shortening: Resolution after opening a totally occluded right coronary artery

Abstract

Acute myocardial ischemia induces reduced systolic shortening and causes postsystolic shortening (PSS). Right ventricular (RV) PSS in coronary artery disease has been less studied. We present here the case of a 51-year-old woman admitted with a non-ST segment elevation myocardial infarction and significant PSS in the RV free-wall segments on two-dimensional speckle tracking echocardiography, suggesting ongoing ischemia. A cardiac CT demonstrated occluded proximal right coronary artery with a low-attenuated/soft plaque, confirmed by coronary angiography which was treated by percutaneous coronary intervention. At 3-week follow-up, there was complete resolution of the RV-PSS, with a more synchronized pattern of maximum myocardial shortening at systole.

Quantitative evaluation of cardiac magnetic resonance feature tracking (CMR-FT) derived strain in patients with ST-elevation myocardial infarction

“…Strain imaging also allows assessment of regional LV dysfunction/ischemia when segmental strain is impaired (less negative value) or show other pathological patterns such early systolic lengthening or post-systolic shortening of both left and right ventricular (RV) myocardium. [11][12][13][14] However, STE imaging is also subject to all the inherent limitations of ultrasound such as image quality and operator dependency, as well as the challenges with assessing strain of cardiac chambers with thin walls such as the atria and the RV free wall. Hence, although most evidence and clinical experience regarding strain measures have been obtained by echocardiography, the clinical applicability of strain imaging has now evolved into the field of cardiac magnetic resonance (CMR).…”