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. 2018 Mar;41(3):413-418.
doi: 10.1002/clc.22890. Epub 2018 Mar 25.

The impact of right ventricular function assessed by 2-dimensional speckle tracking echocardiography on early mortality in patients with inferior myocardial infarction

Batur G Kanar  1 , Mustafa K Tigen  1 , Murat Sunbul  1 , Altug Cincin  1 , Halil Atas  1 , Alper Kepez  1 , Beste Ozben  1
Affiliations

The impact of right ventricular function assessed by 2-dimensional speckle tracking echocardiography on early mortality in patients with inferior myocardial infarction

Batur G Kanar et al. Clin Cardiol. 2018 Mar.

Abstract

Background: Right ventricular (RV) involvement in inferior myocardial infarction (MI) increases in-hospital morbidity and mortality.

Hypothesis: RV systolic dysfunction assessed by 2-dimensional speckle tracking echocardiography (STE) might be a predictor of early mortality in patients with acute inferior MI.

Methods: Eighty-one consecutive patients with acute inferior MI (mean age, 60.8 ± 12.7 years; 18 females) were included. RV myocardial involvement was defined as an elevation >1 mm in V1 or V4 R within 12 hours of symptom onset. RV function was assessed by STE. Patients were followed for 30 days for all-cause mortality.

Results: Thirty-eight patients had RV myocardial involvement, and they had significantly lower tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (RVS), and left ventricular (LV) and RV global longitudinal strain (GLS). Nine patients (11%) died within 30 days. The mean age of mortality group was higher with more female frequency. They had significantly higher pro-BNP, hs-troponin T, and creatinine levels, but lower hemoglobin levels. TIMI 3 flow was significantly less achieved in mortality group. RV myocardial involvement was more frequent in the mortality group, and they had significantly lower TAPSE, RVS, and LV and RV GLS. Multivariate analysis revealed that age and RV GLS were independent predictors of early mortality. RV GLS ≤ -14% predicted early mortality in patients with acute inferior MI with a sensitivity of 88.9% and a specificity of 62.5% (AUC: 0.817, P = 0.002).

Conclusions: RV GLS may be useful in predicting early mortality in patients with acute inferior MI.

Keywords: Inferior Myocardial Infarction; Mortality; Right Ventricular Function; Speckle Tracking Echocardiography.

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Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Figure 1
Figure 1
ROC analysis revealed that a RV GLS ≤ –14% predicted early mortality in patients with acute inferior MI with a sensitivity of 88.9%, specificity of 62.5%, positive predictive value of 22.9%, and negative predictive value 97.8%. AUC: 0.817, 95% CI: 0.652‐0.982, P = 0.002. Abbreviations: AUC, area under the curve; CI, confidence interval; MI, myocardial infarction; ROC, receiver operating characteristic; RV GLS, right ventricular global longitudinal strain
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References

    1. Wang JY, Goodman SG, Saltzman I, et al; Global Registry of Acute Coronary Events (GRACE/GRACE‐2); Canadian Registry of Acute Coronary Events (CANRACE) Investigators . Cardiovascular risk factors and in‐hospital mortality in acute coronary syndromes: insights from the Canadian Global Registry of Acute Coronary Events. Can J Cardiol. 2015;31:1455–1461. - PubMed
    1. Khosoosi Niaki M, Abbaszade Marzbali N, Salehiomran M. Clinical manifestations of right ventricle involvement in inferior myocardial infarction. Caspian J Intern Med. 2014;5:13–16. - PMC - PubMed
    1. Khan S, Kundi A, Sharieff S. Prevalence of right ventricular myocardial infarction in patients with acute inferior wall myocardial infarction. Int J Clin Pract. 2004;58:354–357. - PubMed
    1. Isner JM, Roberts WC. Right ventricular infarction complicating left ventricular infarction secondary to coronary heart disease: frequency, location, associated findings and significance from analysis of 236 necropsy patients with acute or healed myocardial infarction. Am J Cardiol. 1978;42:885–894. - PubMed
    1. Yoshino H, Udagawa H, Shimizu H, et al. ST‐segment elevation in right precordial leads implies depressed right ventricular function after acute inferior myocardial infarction [published correction appears in Am Heart J. 1998;136:5]. Am Heart J. 1998;135:689–695. - PubMed

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