Evaluation of right atrial function by two-dimensional speckle-tracking echocardiography in patients with right ventricular myocardial infarction

Int J Cardiovasc Imaging. 2017 Jan;33(1):47-56. doi: 10.1007/s10554-016-0975-0. Epub 2016 Sep 8.

Abstract

Right ventricular myocardial infarction (RVMI) damages the systolic and diastolic functions of the RV, so the right atrium interacts with the RV with an acutely altered function. The aim of our study was to compare right atrial function as evaluated by 2D speckle-tracking echocardiography (2DSTE) between patients with inferior wall myocardial infarction (INFMI) and patients affected by both inferior myocardial infarction and right ventricular myocardial infarction (INFMI + RVMI). Our study recruited 70 consecutive patients with INFMI (43 patients without RVMI and 27 patients with RVMI). Right atrial function was evaluated by 2DSTE. Early diastolic strain, systolic strain rate, absolute value of early diastolic strain rate, expansion index, and diastolic emptying index of the right atrium were reduced in the patients with INFMI + RVMI compared to the patients with INFMI. The area under the curve for early diastolic strain for INFMI diagnosis was 0.682 (p value = 0.011, 95 % CI 0.550-0.815). Right atrial early diastolic longitudinal strain <27.5 % had 59.3 % sensitivity and 79.1 % specificity for the discrimination of INFMI + RVMI from INFMI. Our results demonstrated that right atrial reservoir and conduit functions were impaired in the patients with INFMI + RVMI compared with the patients with INFMI.

Keywords: 2D speckle-tracking echocardiography; Myocardial infarction; Right atrium; Right ventricle.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Area Under Curve
  • Atrial Function, Right*
  • Echocardiography / methods*
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Inferior Wall Myocardial Infarction / diagnostic imaging*
  • Inferior Wall Myocardial Infarction / physiopathology
  • Iran
  • Male
  • Middle Aged
  • Myocardial Contraction
  • Predictive Value of Tests
  • ROC Curve
  • Reproducibility of Results
  • Stress, Mechanical
  • Ventricular Function, Right