Assessment of right ventricular functions by echocardiography in patients with acute myocardial infarction in North India: An observational study

Abstract

Background: Right Ventricle (RV) dysfunction may be primarily attributed to abnormality of RV myocardium or secondary to left ventricle (LV) dysfunction, as a consequence of “Ventricular Interdependence” between the two ventricles, as they are encircled by common muscle fibres, share a common septal wall and are enclosed within a common pericardium6,7 Early recognition of RV dysfunction is warranted but till today it remains a challenging task because of complex structure and asymmetric. Aims: To study Right Ventricular functions in Acute coronary syndrome. Method: All patients with first presentation of Acute STEMI/NSTEMI with a total of 100 patients who match our inclusion criteria were studied from June 2015 to May 2017 on Phillips Epiq 7 echocardiography Machine with follow up echocardiography at discharge. Results: A total of 100 patients of acute myocardial infarction were studied with 73% STEMI & 27% NSTEMI & among these 68% were anterior wall MI (AWMI) & 32% inferior wal MI (IWMI). Prevalence of different risk factors observed in study population was as follows: Dyslipidaemia in 68% patients, diabetes mellitus 64%, hypertension was present in 54%, Family history of coronary artery disease (CAD) was present in 43 % of patients & Smoking was prevalent in 27 % of cases. The present study demonstrated presence of RV dysfunction assessed by echocardiography, in acute MI (STEMI/NSTEMI) irrespective of infarction location and was more commonly seen in AWMI than IWMI. Conclusions: The present study demonstrates presence of RV dysfunction assessed by echocardiography (RVEDD (RV end diastolic diameter), TAPSE (transannular plane systolic excursion), FAC (Fractional area change), E/E', RV MPI (Myocardial performance index) by TDI (tissue Doppler imaging)), in acute MI (STEMI/NSTEMI) irrespective of infarction location and was more commonly seen in AWMI than IWMI. This study demonstrated presence of RV dysfunction in acute MI more so in STEMI than NSTEMI with high morbidity and mortality in patients with RV dysfunction irrespective of site of infarction.