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Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

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Abstract

To assess the pattern of right ventricular (RV) functional recovery in a cohort of patients with successful reperfusion of a first episode of acute myocardial infarction (AMI) with 2D speckle-tracking echocardiography and cardiac magnetic resonance imaging (CMR). Ninety-five revascularized AMI patients were prospectively included (56.8 ± 11.1 years, 48 inferior, 47 anterior). RV function was assessed by echocardiography and CMR within the initial 72 h and 6 months later. A RV global strain was calculated while averaging strain values from septal, lateral and inferior walls. At the acute phase, RVEFCMR was lower in inferior than in anterior AMI patients (52.5 ± 6.8 vs. 56.0 ± 4.8, p = 0.006). Similarly, RV global, inferior and lateral strains were lower in inferior MI patients (p < 0.001 for all) whereas septal strain was not significantly different across groups. At 6 months, RVEFCMR and all strain parameters improved compared to baseline. Improvements were more substantial for patients with inferior than with anterior MI. RV parameters ultimately reached similar levels in the two groups at 6 months except for inferior strain which remained lower in patients with inferior MI (−24.5 ± 6.5 vs. −27.5 ± 5.4, p = 0.03). In low risk patients after AMI, RV function ultimately recovered over the 6 months of follow up. Higher levels of both initial impairment and subsequent recovery were observed for inferior MI. Although RV function was relatively preserved in these patients, RV strain analysis revealed a persistent impairment of RV inferior strain in patients with inferior MI, which may not be identified by RVEFCMR or conventional echocardiographic parameters.

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Acknowledgments

This REMI study was supported by PHRC (Programme Hospitalier de Recherche Clinique).

Conflict of interest

None.

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Authors and Affiliations

  1. Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, allée du Morvan, 54511, Vandœuvre-lès-Nancy, France

    Olivier Huttin, Marine Di Meglio, Frédéric Moulin, Simon Lemoine, Yves Juillière & Christine Selton-Suty

  2. Service de Réanimation Médicale, Hôpital Central, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France

    Jérémie Lemarié

  3. Centre d’Investigations Cliniques—INSERM, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France

    Nicolas Girerd & Jacques Felblinger

  4. Service de Médecine Nucléaire, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France

    Damien Mandry & Pierre-Yves Marie

Authors
  1. Olivier Huttin
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  2. Jérémie Lemarié
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  3. Marine Di Meglio
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  4. Nicolas Girerd
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  5. Damien Mandry
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  6. Frédéric Moulin
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  7. Simon Lemoine
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  8. Yves Juillière
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  9. Jacques Felblinger
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  10. Pierre-Yves Marie
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  11. Christine Selton-Suty
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Corresponding author

Correspondence to Olivier Huttin.

Additional information

Clinical trial registration: http://clinicaltrials.gov/show/NCT01109225; NCT01109225.

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Huttin, O., Lemarié, J., Di Meglio, M. et al. Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography. Int J Cardiovasc Imaging 31, 537–545 (2015). https://doi.org/10.1007/s10554-014-0585-7

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  • DOI: https://doi.org/10.1007/s10554-014-0585-7

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