Assessment of Right Ventricular function by Echocardiograpy in Inferior wall Myocardial Infarction and Angiographic correlation to Proximal Right Coronary Artery Stenosis

Right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we have attempted to correlate various indices of RV function assessed by echocardiography with presence of proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI. Methods: 102 patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and RV function was assessed by RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients underwent coronary angiogram (CAG) subsequently and they were classified into group 1 and group 2 based on the presence or absence, respectively, of a significant proximal RCA stenosis. Results: There were 102 patients with first episode of IWMI of which 78 patients underwent CAG. There was significant difference between group 1 (n = 26) and group 2 (n=52) in TAPSE, MPI by tissue Doppler and in tissue Doppler systolic velocity from RV free wall. There was a good inter observer correlation for TAPSE, MPI by TDI, and S0 velocity. RV function indices like TAPSE, MPI-TDI and S0 velocity are useful in predicting proximal RCA stenosis in first episode of acute IWMI.

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