RIGHT VENTRICULAR FUNCTION IN PATIENTS WITH FIRST ACUTE MYOCARDIAL INFARCTION

rupesh george

Abstract


ABSTRACT

Background: Right ventricular(RV) dysfunction predicts poor prognosis in acute myocardial infarction. The sensitivity of clinical findings for RVMI is as low as 10%. Right side ECG leads give information of right ventricular free wall only. As Tissue Doppler study of  RV gives better information of global RV function we intended to do this study.

 

Objectives: The present study was conducted to investigate the effect of different infarction sites on right ventricular (RV) functional changes by echocardiogram in patients with first acute ST-elevation myocardial infarction.

 

Methodology: The study was a descriptive cross sectional study with the study setting from the In-patients of the departments of internal medicine and cardiology. Clinical findings and echocardiography of  consecutive 200 patients with myocardial infarction during the period of Dec 2012 to Dec 2013, who met the inclusion and exclusion criteria, were taken. Age, gender distribution, risk factors, clinical findings, ECG and Echocardiographic findings including, TAPSE, Tissue Doppler MPI, ejection fraction were analysed.

 

Results: The prevalence of RV dysfunction in echo cardiogram was comparable in both AWMI and IWMI. In our study 30.3% (n= 27) had abnormal TAPSE in AWMI and 34.2% (n = 38) in IWMI. Tissue Doppler MPI abnormality was seen in 34 patients (38.2%) with Anterior Wall MI and 55 patients (49.5%) with inferior wall MI. Impairment of  LV Ejection fraction was more frequent in AWMI (84.3%{ n = 75 } ) than in IWMI (18.9%).

 

Conclusion: Even though, clinical RV involvement was more in cases of inferior wall myocardial infarction, echocardiographically, the incidence was comparable in  both inferior wall MI and anterior wall MI.

 

Key Words:  RV  function , myocardial infarction, TAPSE , Tissue Doppler MPI.

 

 

 


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