Assessment of right ventricular diastolic function by tissue Doppler imaging in patients with acute right ventricular myocardial infarction.
BACKGROUND
It is known that right ventricular systolic parameters as assessed by color tissue Doppler imaging (TDI) are abnormal in patients with inferior wall ST elevation myocardial infarction (IWMI) with right ventricular myocardial infarction (RVMI). This study was undertaken to determine right ventricular diastolic function as assessed by TDI in patients with acute RVMI.


METHODS
Thirty-five patients with first IWMI were studied and compared with 20 age-matched healthy controls, and categorized into those with (14 patients) and without (21 patients) RVMI based on standard ECG criteria. Peak systolic, peak early and late diastolic velocities (Sm, Em, and Am), Em/Am ratio along with time to Sm (ECG Q-Sm) and time to Em (ECG Q-Em) were acquired from the apical 4-chamber view at the lateral side of tricuspid annulus using TDI.


RESULTS
Sm, Em, and Em/Am ratio was reduced significantly in patients with RVMI as compared with those without RVMI and healthy individuals (Sm [11.1 + or - 2.9] vs. [14 + or - 1.9] and [14.5 + or - 2.1] cm/sec, P < 0.01; Em [9.2 + or - 3.5] vs. [12.9 + or - 3] and [14.0 + or - 2.0] cm/sec, P < 0.01; Em/Am ratio 0.53 + or - 0.2 vs. 0.78 + or - 0.19 and 0.8 + or - 0.3 [P < 0.0001]). Among the intervals, there was significant prolongation of Q-Em (558 + or - 14.8 vs. 507 + or - 16.2 and 480 + or - 20 ms [P < 0.0001]) but Q-Sm and Am were not statistically different between the groups.


CONCLUSIONS
Right ventricular TDI diastolic parameters are abnormal in patients with RVMI. The method of recording the velocities and time intervals are simple and can be used to assess right ventricular diastolic function in patients with RVMI. (Echocardiography 2010;27:539-543).
Mukhaini
Mohammed
M
Department of Cardiology, Royal Hospital, Muscat, Oman.
Prashanth
Panduranga
P
Abdulrehman
Said
S
Zadjali
Majid
M
D016022:Case-Control Studies; D015897:Comorbidity; D003971:Diastole; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*