The diagnostic and prognostic value of right ventricle systolic and diastolic function in inferior myocardial infarction patients

Abstract

Background: Inferior myocardial infarction (MI) with right ventricular (RV) involvement will increase mortality and morbidity. Data of systolic and diastolic RV function in inferior ST-segment elevation MI (STEMI) are useful to predict the RV involvement. Aims: To evaluate the prognostic and diagnostic significance of RV systolic and diastolic function compared to RVMI diagnostic criteria by electrocardiography in inferior MI patients. Methods: Consecutive patients with first, acute, inferior STEMI were prospectively assessed. The RVMI was defined as an ST segment elevation ≥ 0.1 mV in lead V4R. Echocardiography was performed within 24 hours of the inferior STEMI symptoms. We assessed the RVMI diagnostic criteria in inferior MI patients using echocardiography. Results: Out of 31 patients (mean age 56.39 ± 9.02 years), RVMI by electrocardiography and echocardiography was found in 18 (37%). Moreover, multivariate analysis showed that two variables — RV systolic and diastolic function, were independent predictors of RVMI in inferior MI patients. Sensitivity and specificity of the RV systolic function were 94.4% and 69.2%, respectively, while RV diastolic functions were 44% and 76.9%, respectively. Conclusion: RV systolic function predict RVMI with relatively high sensitivity and specificity. RV diastolic function predicts RVMI with relatively low sensitivity but with high specificity. Keywords: Tissue Doppler Imaging, Right ventricular, Myocardial infarction, Systolic function, Diastolic function Received: 5 September 2017, Reviewed: 17 October 2017, Received: in revised form 22 January 2018, Accepted: 28 February 2018 DOI: 10.35898/ghmj-21567