The Role of Echocardiography in the Detection of Subtle Right Ventricle Dysfunction in Inferior Myocardial Infarction after Successful Primary PCI

Abstract

Background: Globally, coronary artery disease (CAD), is the primary cause of death. CAD claims the lives of more than seven million people annually, making up 12.8% of all fatalities.

A myocardial infarction with ST-segment elevation (STEMI) is the most serious form of CAD.

 This research aimed to evaluate the effectiveness of echocardiography in the identification of concealed RV dysfunction within 30 minutes of initial percutaneous coronary intervention (PCI), In patients with inferior STEMI who do not show clinical or electrocardiographic signs of the right ventricle (RV) infarction.

Methodology: Eighty-nine individuals with inferior STEMI were included in this cross-sectional observational research. The research was conducted at Helwan University Hospital and El-Zaitoun Specialized Hospital from June 2022 to June 2023.

Results: We found that concealed RV systolic dysfunction in 35 patients (39%) of the studied group, the key echocardiographic parameters (Tricuspid Annular Plane Systolic Excursion, tissue Doppler S', RV fractional area change (RVFAC), left ventricular ejection fraction (LVEF), and RV speckle tracking) were significantly impaired in the RV systolic dysfunction group. RVFAC was the most accurate detector of RV systolic dysfunction. Also, male gender, older ages, diabetes mellitus, hypertension, higher body mass index, and longer door-to-balloon time were higher in patients with RV systolic dysfunction.

Conclusion: Concealed RV systolic dysfunction isn't uncommon in patients with inferior STEMI due to right coronary artery occlusion, about 39%. The current study highlighted RVFAC as the best echocardiographic test to elicit RV systolic dysfunction resulting from inferior wall STEMI.