Right ventricular function in patients with acute anterior myocardial infarction: tissue Doppler echocardiographic approach.
OBJECTIVE
Our purpose was to investigate the right ventricular (RV) performance of patients with a first acute anterior myocardial infarction (AAMI) by using pulsed wave Doppler tissue (PWDT) samplings of tricuspid annulus and RV free wall.


RESULTS
The study group included 31 patients with AAMI and 20 age-matched controls. Conventional indexes of RV functions were the magnitude of tricuspid annular plane systolic excursion (TAPSE), and the transpulmonary and transtricuspid Doppler parameters. PWDT velocities were obtained by placing the sample volume at the lateral tricuspid annulus and the mid-segment of RV free wall; the peak systolic (S), early (E) and late (A) diastolic PWDT velocities and time intervals from ECG-Q wave to their peaks were analysed. Standard indexes were comparable except TAPSE that was significantly lower in AAMI-patients (p < 0.001). S velocities were similar; A of both regions (p = 0.018 and 0.012) and E of RV free wall (p = 0.011) were significantly increased in AAMI-group. Q-Sa intervals in both regions (p = 0.007 and 0.015) and Q-Ea of tricuspid annulus (p = 0.045) were significantly shorter in patients with AAMI. TAPSE and E of RV free wall had significant negative correlations with left ventricular systolic volume index and right atrial filling fraction (AFF), respectively (r = -0.46, p = 0.01 for both). A of tricuspid annulus had a positive correlation with left AFF (r = 0.42, p = 0.02).


CONCLUSIONS
PWDT imaging of tricuspid annulus and RV free wall is capable to sensitively detect the adaptive mechanisms and unfavourable diastolic properties of RV dynamics in patients with AAMI.
Akdemir
Osman
O
Trakya University, School of Medicine, Cardiology Department, Edirne, Turkey. oakdemir@superonline.com
Yildiz
Mustafa
M
Sürücü
Hüseyin
H
Dagdeviren
Bahadir
B
Erdogan
Okan
O
Ozbay
Gültac
G
D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D015588:Observer Variation; D011336:Probability; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging*; D016278:Ventricular Function, Right