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Echocardiographic assessment of right ventricle free wall strain for prediction of right coronary artery proximal lesion in patients with inferior myocardial infarction

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Abstract

In this study, our objective was to evaluate right ventricular functions with speckle-tracking and conventional echocardiographic methods in patients with acute inferior myocardial infarction and to investigate the correlation between the echocardiographic parameters and the prediction of the proximal RCA lesions. 77 patients were included in this study. Patients with a RCA occluded proximal to the right ventricular branch were assigned to Group 1 and patients with an RCA occlusion distal to the right ventricle branch were assigned to Group 2. All echocardiographic examinations were carried out within 24 h after PTCA, which was performed for the treatment of inferior myocardial infarction. RV TAPSE, RV TDI Sm, FAC, RV-FW strain, RV-FW SRE′, RV-FW SRA′ and RV E/Em which were statistically significant in univariate analysis were evaluated with the help of the multivariate logistic regression analysis. In the multivariate logistic regression test; RV-FW strain (OR 0.751, 95% CI 0.592–0.954, p = 0.019) and RV E/Em (OR 0.442, 95% CI 0.252–0.776, p = 0.004) were determined as the independent predictive parameters for proximal RCA occlusion. In the ROC analysis, RV-FW strain > − 14.75% predicted the proximal RCA occlusion with 83% sensitivity and 61% specificity (AUC = 0.81, p < 0.001) and RV E/Em > 6.25 with 68% sensitivity and 80% specificity (AUC = 0.79, p < 0.001). In this study, we demonstrated that decreased RV FW strain and increased RV E/Em were predictive parameters for the presence of the proximal RCA in patients with acute inferior MI.

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References

  1. Goldstein JA (1998) Right heart ischemia: pathophysiology, natural history, and clinical management. Prog Cardiovasc Dis 40(4):325–341

    Article  PubMed  CAS  Google Scholar 

  2. Goldstein JA (1999) Pathophysiology and clinical management of right heart ischemia. Curr Opin Cardiol 14(4):329–339

    Article  PubMed  CAS  Google Scholar 

  3. Bueno H, Lopez-Palop R, Bermejo J, Lopez Sendon JL, Delcan JL (1997) In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement. Circulation 96(2):436–441

    Article  PubMed  CAS  Google Scholar 

  4. Kakouros N, Cokkinos DV (2010) Right ventricular myocardial infarction: pathophysiology, diagnosis, and management. Postgrad Med J 86(1022):719–728

    Article  PubMed  Google Scholar 

  5. El Sebaie MH, El Khateeb O (2016) Right ventricular echocardiographic parameters for prediction of proximal right coronary artery lesion in patients with inferior wall myocardial infarction. J Saudi Heart Assoc 28(2):73–780

    Article  PubMed  Google Scholar 

  6. Ozdemir K, Altunkeser BB, Icli A, Ozdil H, Gök H (2003) New parameters in identification of right ventricular myocardial infarction and proximal right coronary artery lesion. Chest 124(1):219–226.

    Article  PubMed  Google Scholar 

  7. Bayata S, Avcı E, Yeşil M, Arıkan E, Postacı N, Tülüce SY (2011) Tricuspid annular motion in right coronary artery-related acute inferior myocardial infarction with or without right ventricular involvement. Anadolu Kardiyol Derg 11(6):504–508

    PubMed  Google Scholar 

  8. Hsiao SH, Chiou KR, Huang WC, Cheng CC, Kuo FY, Lin KL, Lin SK, Lin SL (2010) Right ventricular infarction and tissue Doppler imaging insights from acute inferior myocardial infarction after primary coronary intervention. Circ J 74(10):2173–2180

    Article  PubMed  Google Scholar 

  9. Zaborska B, Makowska E, Pilichowska E, Maciejewski P, Bernarz B, Wasek W, Stec S, Budaj A (2011) The diagnostic and prognostic value of right ventricular myocardial velocities in inferior myocardial infarction treated with primary percutaneous intervention. Kardiol Pol 69(10):1054–1061

    PubMed  Google Scholar 

  10. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1–39

    Article  PubMed  Google Scholar 

  11. Sevimli S, Gundogdu F, Aksakal E, Arslan S, Tas H, Islamoglu Y, Buyukkaya E, Gurlertop HY, Senocak H (2007) Right ventricular strain and strain rate properties in patients with right ventricular myocardial infarction. Echocardiography 24(7):732–738

    Article  PubMed  Google Scholar 

  12. Cameli M, Mondillo S, Solari M, Righini FM, Andrei V, Contaldi C, De Marco E, Di Mauro M, Esposito R, Gallina S, Montisci R, Rossi A, Galderisi M, Nistri S, Agricola E, Mele D (2016) Echocardiographic assessment of left ventricular systolic function: from ejection fraction to torsion. Heart Fail Rev 2(1):77–94

    Article  Google Scholar 

  13. Mondillo S, Galderisi M, Mele D, Cameli M, Lomoriello VS, Zacà V, Ballo P, D’Andrea A, Muraru D, Losi M, Agricola E, D’Errico A, Buralli S, Sciomer S, Nistri S, Badano L (2011) Speckle tracking echocardiography a new technique for assessing myocardial function. J Ultrasound Med 30(1):71–83

    Article  PubMed  Google Scholar 

  14. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K, Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, van ‘t Hof A, Widimsky P, Zahger D (2012) ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 33(20):2569–2619

    Article  CAS  Google Scholar 

  15. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ, Chamber Quantification Writing Group, American Society of Echocardiography’s Guidelines and Standards Committee, European Association of Echocardiography (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463

    Article  PubMed  Google Scholar 

  16. Jurado-Román A, Agudo-Quílez P, Rubio-Alonso B, Molina J, Díaz B, García-Tejada J, Martín R, Tello R (2016) Superiority of wall motion score index over left ventricle ejection fraction in predicting cardiovascular events after an acute myocardial infarction. Eur Heart J Acute Cardiovasc Care. https://doi.org/10.1016/j.carrev.2017.10.014.

    Article  PubMed  Google Scholar 

  17. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10(2):165–193

    Article  PubMed  Google Scholar 

  18. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23(7):685–713

    Article  PubMed  Google Scholar 

  19. Leitman M, Lysyansky P, Sidenko S, Shir V, Peleg E, Binenbaum M, Kaluski E, Krakover R, Vered Z (2004) Two-dimensional strain-a novel software for real time quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr 17(10):1021–1029

    Article  PubMed  Google Scholar 

  20. Pirat B, McCulloch ML, Zoghbi WA (2006) Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. Am J Cardiol 98(5):699–704

    Article  PubMed  Google Scholar 

  21. Jurcut R, Giusca S, La Gerche A, Vasile S, Ginghina C, Voigt JU (2010) The echocardiographic assessment of the right ventricle: what to do in 2010? Eur J Echocardiogr 11(2):81–96

    Article  PubMed  Google Scholar 

  22. Rallidis LS, Makavos G, Nihoyannopoulos P (2014) Right ventricular involvement in coronary artery disease: role of echocardiography for diagnosis and prognosis. J Am Soc Echocardiogr 27(3):223–229

    Article  PubMed  Google Scholar 

  23. Jugdutt BI, Sussex BA, Sivaram CA, Rossall RE (1984) Right ventricular infarction: two-dimensional echocardiographic evaluation. Am Heart J 107(3):505–518

    Article  PubMed  CAS  Google Scholar 

  24. Anavekar NS, Gerson D, Skali H, Kwong RY, Yucel EK, Solomon SD (2007) Two-dimensional assessment of right ventricular function: an echocardiographic- MRI correlative study. Echocardiography 24(5):452–456

    Article  PubMed  Google Scholar 

  25. Lemarié J, Huttin O, Girerd N, Mandry D, Juillière Y, Moulin F, Lemoine S, Beaumont M, Marie PY, Selton-Suty C (2015) Usefulness of speckle-tracking imaging for right ventricular assessment after acute myocardial infarction: a magnetic resonance imaging echocardiographic comparison within the relation between aldosterone and cardiac remodeling after myocardial infarction study. J Am Soc Echocardiogr 28(7):818–827

    Article  PubMed  Google Scholar 

  26. Wang J, Prakasa K, Bomma C, Tandri H, Dalal D, James C, Tichnell C, Corretti M, Bluemke D, Calkins H, Abraham TP (2007) Comparison of novel echocardiographic parameters of right ventricular function with ejection fraction by cardiac magnetic resonance. J Am Soc Echocardiogr 20(9):1058–1064

    Article  PubMed  Google Scholar 

  27. Dokainish H, Abbey H, Gin K, Ramanathan K, Lee PK, Jue J (2005) Usefulness of tissue Doppler imaging in the diagnosis and prognosis of acute right ventricular infarction with inferior wall acute left ventricular infarction. Am J Cardiol 95(9):1039–1042

    Article  PubMed  Google Scholar 

  28. Hutyra M, Skála T, Horák D, Köcher M, Tüdös Z, Zapletalová J, Přeček J, Louis A, Smékal A, Táborský M (2015) Echocardiographic assessment of global longitudinal right ventricular function in patients with an acute inferior ST elevation myocardial infarction and proximal right coronary artery occlusion. Int J Cardiovasc Imaging 31(3):497–507

    Article  PubMed  Google Scholar 

  29. Chang WT, Tsai WC, Liu YW, Lee CH, Liu PY, Chen JY, Li YH, Tsai LM (2014) Changes in right ventricular free wall strain in patients with coronary artery disease involving the right coronary artery. J Am Soc Echocardiogr 27(3):230–238

    Article  PubMed  Google Scholar 

  30. Mukhaini M, Prashanth P, Abdulrehman S, Zadjali M (2010) Assessment of right ventricular diastolic function by tissue Doppler imaging in patients with acute right ventricular myocardial infarction. Echocardiography 27(5):539–543

    Article  PubMed  Google Scholar 

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Correspondence to Cetin Gecmen.

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Gecmen, C., Candan, O., Kahyaoglu, M. et al. Echocardiographic assessment of right ventricle free wall strain for prediction of right coronary artery proximal lesion in patients with inferior myocardial infarction. Int J Cardiovasc Imaging 34, 1109–1116 (2018). https://doi.org/10.1007/s10554-018-1325-1

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