Evaluation of Right Ventricular Functions Using Noninvasive Methods in Patients Followed in the Cardiology Clinic with Inferior Myocardial Infarction

Abstract

Aim: Coronary artery disease (CAD) continues to be one of the leading causes of morbidity and mortality in developed and developing countries. In this study, the right ventricular functions of patients with inferior myocardial infarction (inferior MI) were investigated. Material and Method: In this prospective study, patients who were followed up with inferior MI between January 2023 and June 2023, along with a healthy control group, were included. Transthoracic echocardiography was performed on all patients under appropriate conditions and recorded. Results: A total of 103 patients (68 males, average age: 51±12 years) were included in the study. The patients were divided into two groups: patients (n=50) and healthy controls (n=53). In single and multiple regression analyses between groups, age, glucose, tricuspid annular plane systolic excursion (TAPSE), and TAPSE/ pulmonary arterial systolic pressure (SPAP) were shown to be independent risk factors for inferior myocardial infarction. Conclusion: TAPSE and TAPSE/SPAP are independent risk factors for inferior myocardial infarction.

Keywords

• inferior myocardial infarction
• tricuspid annular plane systolic movement
• echocardiography

References

1. 1. Gao D, Ning N, Guo Y, Ning W, Niu X, Yang J. Computed tomography for detecting coronary artery plaques: a metaanalysis. Atherosclerosis. 2011;219(2):603–9.
2. 2. Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18–e209.
3. 3. Sun ZH, Cao Y, Li HF. Multislice computed tomography angiography in the diagnosis of coronary artery disease. J Geriatr Cardiol. 2011;8(2):104–13.
4. 4. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010;121(7):948–54.
5. 5. Achar SA, Kundu S, Norcross WA. Diagnosis of acute coronary syndrome. Am Fam Physician. 2005;72(1):119–26.
6. 6. Platelet Glycoprotein IIiUARSUITTI. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. N Engl J Med. 1998;339(7):436–43.
7. 7. Cohen M, Demers C, Gurfinkel EP, Turpie AG, Fromell GJ, Goodman S, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group. N Engl J Med. 1997;337(7):447–52.
8. 8. BERKALP B. Aterom Plağı Morfolojisi ve Klinikle İlişkisi. Turkiye Klinikleri Journal of Cardiology. 2004;17(2):61–71.

9. 9. Libby P. Coronary artery injury and the biology of atherosclerosis: inflammation, thrombosis, and stabilization. Am J Cardiol. 2000;86(8B):3J-8J;discussion J-9J.
10. 10. Tei C. New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol. 1995;26(2):135–6.
11. 11. Hameed A, Condliffe R, Swift AJ, Alabed S, Kiely DG, Charalampopoulos A. Assessment of Right Ventricular Function-a State of the Art. Curr Heart Fail Rep. 2023;20(3):194–207.
12. 12. Edward J, Banchs J, Parker H, Cornwell W. Right ventricular function across the spectrum of health and disease. Heart. 2023;109(5):349–55.
13. 13. Feigenbaum H, Armstrong WF, Ryan T. Feigenbaum1s Echocardiography. Lippincott 2005;6:182–4. Williams & Wilkins.
14. 14. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018;138(20):e618–e51.
15. 15. Pepine CJ, Allen HD, Bashore TM, Brinker JA, Cohn LH, Dillon JC, et al. ACC/AHA guidelines for cardiac catheterization and cardiac catheterization laboratories. American College of Cardiology/American Heart Association Ad Hoc Task Force on Cardiac Catheterization. Circulation. 1991;84(5):2213–47.
16. 16. Dell’Italia LJ, Starling MR, Crawford MH, Boros BL, Chaudhuri TK, O’Rourke RA. Right ventricular infarction: identification by hemodynamic measurements before and after volume loading and correlation with noninvasive techniques. J Am Coll Cardiol. 1984;4(5):931–9.
17. 17. Kaul S, Tei C, Hopkins JM, Shah PM. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J. 1984;107(3):526–31.
18. 18. Ghio S, Recusani F, Klersy C, Sebastiani R, Laudisa ML, Campana C, et al. Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy. Am J Cardiol. 2000;85(7):837–42.
19. 19. Ueti OM, Camargo EE, Ueti Ade A, de Lima-Filho EC, Nogueira EA. Assessment of right ventricular function with Doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography. Heart. 2002;88(3):244–8.
20. 20. Araştırma K, Demirelli S, Yilmaz H, Ermis E, Ipek E, Inci S, et al. MN Kardiyoloji 22/2015 İritabl Barsak Sendromlu Hastalarda Sağ Ventrikül Sistolik ve Diyastolik Fonksiyonlarının İki Boyutlu Speckle Tracking Ekokardiyografi ile Değerlendirilmesi Right Ventricular Systolic and Diastolic Functions Using TwoDimensional Speckle Tracking Echocardiography in Patients with Irritable Bowel Syndrome. 2015:17–8.
21. 21. Alam M, Wardell J, Andersson E, Samad BA, Nordlander R. Right ventricular function in patients with first inferior myocardial infarction: assessment by tricuspid annular motion and tricuspid annular velocity. Am Heart J. 2000;139(4):7105.
22. 22. Ozdemir K, Altunkeser BB, Icli A, Ozdil H, Gok H. New parameters in identification of right ventricular myocardial infarction and proximal right coronary artery lesion. Chest. 2003;124(1):219–26.
23. 23. Dell’Italia LJ, Starling MR. Right ventricular infarction: an important clinical entity. Curr Probl Cardiol. 1984;9(9):1–72.
24. 24. Lax JA, Bermann AM, Cianciulli TF, Morita LA, Masoli O, Prezioso HA. Estimation of the ejection fraction in patients with myocardial infarction obtained from the combined index of systolic and diastolic left ventricular function: a new method. J Am Soc Echocardiogr. 2000;13(2):116–23.
25. 25. Tei C, Dujardin KS, Hodge DO, Bailey KR, McGoon MD, Tajik AJ, et al. Doppler echocardiographic index for assessment of global right ventricular function. J Am Soc Echocardiogr. 1996;9(6):838–47.
26. 26. Moller JE, Sondergaard E, Poulsen SH, Appleton CP, Egstrup K. Serial Doppler echocardiographic assessment of left and right ventricular performance after a first myocardial infarction. J Am Soc Echocardiogr. 2001;14(4):249–55.
27. 27. Ketikoglou DG, Karvounis HI, Papadopoulos CE, Zaglavara TA, Efthimiadis GK, Parharidis GE, et al. Echocardiographic evaluation of spontaneous recovery of right ventricular systolic and diastolic function in patients with acute right ventricular infarction associated with posterior wall left ventricular infarction. Am J Cardiol. 2004;93(7):911–3