Volume 4, Issue 3, September 2020, Page: 111-118
Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography
Mohamed Fahmy El-Noamany, Cardiology Department, Faculty of Medicine, Menoufiya University, Shibin El Koum, Egypt
Ghada Mahmoud Soltan, Cardiology Department, Faculty of Medicine, Menoufiya University, Shibin El Koum, Egypt
Naglaa Fahim Ahmed, Cardiology Department, Faculty of Medicine, Menoufiya University, Shibin El Koum, Egypt
Haitham Mohamed Omar El-Ahwal, Cardiology Department, Teaching Institutes Organization, Shibin El Koum, Egypt
Received: May 23, 2020;       Accepted: Jun. 18, 2020;       Published: Jul. 23, 2020
DOI: 10.11648/j.ccr.20200403.16      View  177      Downloads  70
Abstract
Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but RA affection is not fully elucidated in patients with myocardial infarction (MI) Objective: To assess RA function by 2-Dimensional speckle tracking echocardiography (2D-STE) imaging in patients with acute first left ventricular (LV) inferior wall MI with and without RV involvement. Patients & methods:-Sixty patients with acute first inferior MI were included in this study; 30 patients had ECG signs of inferior MI without RV infarction (group II) and 30 patients had ECG signs of inferior MI with RV involvement (group III). Twenty five age and sex -matched healthy volunteers were included as a control group (group I). Assessment of RA function was done in all subjects using (2D-STE) for measurements of RA septal and free walls longitudinal strain and strain rate (SR). Results:-RA septal wall & global systolic strain were significantly reduced in group III (22.5±14.8% and 40.4±24.5%) compared to group I (37.5±16.3% and 60.4±22.4%) and group II (35.7±17.4% and 54.9±25.73%), (P<0.001), (P=0.008) respectively. RA septal wall and global early diastolic strain rate were also significantly reduced in group III (- 0.77±0.46 s-1 and – 3.61±0.55 s-1) compared to group I (-1.38±0.74 s-1 and – 4.41±0.67 s-1) and group II (-1.07±0.76 s-1 and -3.73±0.76 s-1), (P=0.005), (P<0.001) respectively. Conclusion:-In patients with first LV inferior wall MI with RV involvement, RA functional parameters (RA septal and global strain and SR) were significantly impaired in comparison to healthy controls and patients with first LV inferior wall MI without RV affection. This result may illustrate the significant relation between RV & RA which is still under research.
Keywords
Right Atrium, Inferior MI, Strain, Strain Rate
To cite this article
Mohamed Fahmy El-Noamany, Ghada Mahmoud Soltan, Naglaa Fahim Ahmed, Haitham Mohamed Omar El-Ahwal, Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography, Cardiology and Cardiovascular Research. Vol. 4, No. 3, 2020, pp. 111-118. doi: 10.11648/j.ccr.20200403.16
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Tadic M. (2015) The right atrium, a forgotten cardiac chamber: an updated review of multimodality imaging. J Clin Ultrasound.
[2]
Kristian T, JS Alpert, Harvey D, White (2007) HDJoint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. Eur Heart J.
[3]
Braat SH, Brugada P, de Zwaan C, Coenegracht JM, Wellens HJ. (1983) Value of electrocardiogramin detecting right ventricular involvement in patients with acute inferior wall myocardial infarction. Heart J.
[4]
D’Alto M, Scognamiglio G, Dimopoulos K, Bossone E, Vizza D, Romeo E, Vonk-Noordergraaf A, Gaine S, Peacock A, Naeije R (2015) Right heart and pulmonary vessels structure and function.
[5]
Dogan C, Ozdemir N, Hatipoglu S, Bakal RB, Omaygenc MO, Dindar B, Candan O, Emiroglu MY, Kaymaz C (2013) Relation of left atrial peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in patients presenting with ST-elevation myocardial infarction.
[6]
Jing Z, Jianchang C, Weiting X, Lan G, Shaikh F, Yanni W (2013) Comparison of left atrial function in healthy individuals versus patients with non-ST-segment elevation myocardial infarction using two-dimensional speckle tracking echocardiography. Cardiovasc J Afr.
[7]
Elnoamany M, Ahmed N, Ragab E (2014) Echocardiographic assessment of right ventricular function in patients with pulmonary hypertension: strain imaging study. Menoufia Med J.
[8]
Monaster S, Ahmad M, Braik A (2014). Comparison between strain and strain rate in hypertensive patients with and without left ventricular hypertrophy: a speckle-tracking study. Menoufia Med J.
[9]
Chockalingam A, Gnanavelu G, Alagesan R, Subramaniam T. (2004) Myocardial performance index in evaluation of acute right ventricular myocardial infarction. Echocardiography.
[10]
Goldstein JA (2012) Acute right ventricular infarction. Cardiol Clin.
[11]
Schiller, N. B., Shah, P. M., Crawford, M., DeMaria, A., Devereux, R., Feigenbaum, H.,… Tajik, A. J. (1989). Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography. Journal of the American Society of Echocardiography, 2 (5), 358–367. doi: 10.1016/s0894-7317(89)80014-8.
[12]
Bussadori, C., Moreo, A., Di Donato, M., De Chiara, B., Negura, D., Dall’Aglio, E., Carminati, M. (2009). A new 2D-based method for myocardial velocity strain and strain rate quantification in a normal adult and paediatric population: assessment of reference values. Cardiovascular Ultrasound, 7 (1). doi: 10.1186/1476-7120-7-8.
[13]
Nourian, S., Hosseinsabet, A., Jalali, A., & Mohseni-Badalabadi, R. (2016). Evaluation of right atrial function by two-dimensional speckle-tracking echocardiography in patients with right ventricular myocardial infarction. The International Journal of Cardiovascular Imaging, 33 (1), 47–56.
[14]
Badran HM, Soltan G, Hassan H, Nazmy A, Faheem N, Saadan H, Yacoub MH. (2012) Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging, Global Cardiology Science & Practice.: 25.
[15]
Haghighi, Z. O., Naderi, N., Amin, A., Taghavi, S., Sadeghi, M., Moladoust, H.,… Haghighi, H. O. (2011). Quantitative assessment of right atrial function by strain and strain rate imaging in patients with heart failure. Acta Cardiologica, 66 (6), 737–742. doi: 10.1080/ac.66.6.2136957.
[16]
Antoni, M. L., ten Brinke, E. A., Atary, J. Z., Marsan, N. A., Holman, E. R., Schalij, M. J., Delgado, V. (2011). Left atrial strain is related to adverse events in patients after acute myocardial infarction treated with primary percutaneous coronary intervention. Heart, 97 (16), 1332–1337. 2011.
[17]
Yan P, Sun B, Shi H, Zhu W, Zhou Q, Jiang Y, Zhu H, Huang G (2012). Left atrial and right atrial deformation in patients with coronary artery disease: a velocity vector imaging-based study. PLoS One 7: e51204.
[18]
Magdy, G., El Ashmawy, H., Zidan, A., & Saeed, A. (2016). Left atrial myocardial deformation characteristics in patients presenting with ST elevation myocardial infarction. The Egyptian Heart Journal, 68 (3), 181–186. doi: 10.1016/j.ehj.05.003.
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