Ahmed Hassouna Bedier Shetaya, Khaled Ahmed Elkhashab, Gomaa Abdel Razek Ahmed
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Patients underwent coronary angiogram within one month and were divided into two groups (A, B) according to angiographic findings based on the presence or absence of significant proximal RCA stenosis.</p></div><div><h3>Results</h3><p>There were 35 patients with first episode of IWMI, group A includes (<em>n</em> 14 patients) and group B includes (<em>n</em> 21patients), There was significant difference between groups in TAPSE (1.28<!--> <!-->cm vs 1.98 <em>p</em> <!--><<!--> <!-->0.001), MPI–TDI (0.69<!--> <!-->±<!--> <!-->0.12 vs 0.38<!--> <!-->±<!--> <!-->0.05 <em>p</em> <!--><<!--> <!-->0.001), and in S′ velocity from RV free wall (0.09<!--> <!-->m/s<!--> <!-->±<!--> <!-->0.02 vs 0.12<!--> <!-->m/s<!--> <!-->±<!--> <!-->0.02 <em>p</em> <!--><<!--> <!-->0.001). It was found that S′<!--> <!--><<!--> <!-->10<!--> <!-->cm/s is a predictor of proximal RCA lesion with a sensitivity of 92.86% and a specificity of 85.71%<!--> <!-->ppv 81.25, npv 94.74, MPI–TDI<!--> <!-->><!--> <!-->0.55 with a sensitivity of 92.86% and a specificity of 100%, 100%<!--> <!-->ppv and 95.45%<!--> <!-->npv, and TAPSE<!--> <!--><<!--> <!-->16<!--> <!-->mm (sensitivity 93%, specificity 100%).</p></div><div><h3>Conclusion</h3><p>RV indices (S′ velocity, MPI–TDI and TAPSE) are useful in predicting proximal RCA as infarct related artery in IWMI.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2016.07.002","citationCount":"2","resultStr":"{\"title\":\"Tissue Doppler tricuspid annular motion in acute inferior wall myocardial infarction and infarction related artery\",\"authors\":\"Ahmed Hassouna Bedier Shetaya, Khaled Ahmed Elkhashab, Gomaa Abdel Razek Ahmed\",\"doi\":\"10.1016/j.ejccm.2016.07.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Patients with inferior wall myocardial infarction (IWMI) associated with right ventricular (RV) infarction have much higher rates of adverse events.</p></div><div><h3>Aim</h3><p>Tissue Doppler (TDI) systolic annular velocity (S′) and myocardial performance index may be useful predictors of proximal right coronary artery (RCA) stenosis as a culprit lesion in inferior wall myocardial infarction.</p></div><div><h3>Methods</h3><p>In a prospective study, patients with first episode of acute IWMI underwent early conventional and tissue Doppler echocardiographic assessment (within 24<!--> <!-->h) of symptom onset and RV indices; Tricuspid annular systolic plane excursion(TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients underwent coronary angiogram within one month and were divided into two groups (A, B) according to angiographic findings based on the presence or absence of significant proximal RCA stenosis.</p></div><div><h3>Results</h3><p>There were 35 patients with first episode of IWMI, group A includes (<em>n</em> 14 patients) and group B includes (<em>n</em> 21patients), There was significant difference between groups in TAPSE (1.28<!--> <!-->cm vs 1.98 <em>p</em> <!--><<!--> <!-->0.001), MPI–TDI (0.69<!--> <!-->±<!--> <!-->0.12 vs 0.38<!--> <!-->±<!--> <!-->0.05 <em>p</em> <!--><<!--> <!-->0.001), and in S′ velocity from RV free wall (0.09<!--> <!-->m/s<!--> <!-->±<!--> <!-->0.02 vs 0.12<!--> <!-->m/s<!--> <!-->±<!--> <!-->0.02 <em>p</em> <!--><<!--> <!-->0.001). 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引用次数: 2
摘要
背景:下壁心肌梗死(IWMI)合并右心室(RV)梗死的患者有更高的不良事件发生率。目的组织多普勒(TDI)收缩期环速度(S’)和心肌功能指数可作为右近端冠状动脉(RCA)狭窄作为下壁心肌梗死罪魁祸首病变的有效预测指标。方法在一项前瞻性研究中，首次发作的急性IWMI患者在早期(24 h内)接受常规和组织多普勒超声心动图评估症状发作和RV指数;测量三尖瓣环形收缩平面偏移(TAPSE)、心肌性能指数(MPI)和左心室游离壁组织多普勒速度。患者在1个月内行冠状动脉造影，根据造影结果根据是否存在显著的近端RCA狭窄分为A、B两组。结果首发IWMI患者35例，A组14例，B组21例，两组间TAPSE差异有统计学意义(1.28 cm vs 1.98 p <0.001), MPI-TDI(0.69±0.12 vs 0.38±0.05 p & lt;0.001)，从RV自由壁上的速度(0.09 m/ S±0.02 vs 0.12 m/ S±0.02 p <0.001)。发现S ' <10 cm/s是RCA近端病变的预测因子，敏感性为92.86%，特异性为85.71%，ppv 81.25, npv 94.74, MPI-TDI >0.55，灵敏度为92.86%，特异性为100%，ppv为100%，npv为95.45%;16mm(灵敏度93%，特异性100%)。结论rv指标(S’velocity、MPI-TDI、TAPSE)可用于预测近端RCA是否为IWMI梗死相关动脉。
Tissue Doppler tricuspid annular motion in acute inferior wall myocardial infarction and infarction related artery
Background
Patients with inferior wall myocardial infarction (IWMI) associated with right ventricular (RV) infarction have much higher rates of adverse events.
Aim
Tissue Doppler (TDI) systolic annular velocity (S′) and myocardial performance index may be useful predictors of proximal right coronary artery (RCA) stenosis as a culprit lesion in inferior wall myocardial infarction.
Methods
In a prospective study, patients with first episode of acute IWMI underwent early conventional and tissue Doppler echocardiographic assessment (within 24 h) of symptom onset and RV indices; Tricuspid annular systolic plane excursion(TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients underwent coronary angiogram within one month and were divided into two groups (A, B) according to angiographic findings based on the presence or absence of significant proximal RCA stenosis.
Results
There were 35 patients with first episode of IWMI, group A includes (n 14 patients) and group B includes (n 21patients), There was significant difference between groups in TAPSE (1.28 cm vs 1.98 p < 0.001), MPI–TDI (0.69 ± 0.12 vs 0.38 ± 0.05 p < 0.001), and in S′ velocity from RV free wall (0.09 m/s ± 0.02 vs 0.12 m/s ± 0.02 p < 0.001). It was found that S′ < 10 cm/s is a predictor of proximal RCA lesion with a sensitivity of 92.86% and a specificity of 85.71% ppv 81.25, npv 94.74, MPI–TDI > 0.55 with a sensitivity of 92.86% and a specificity of 100%, 100% ppv and 95.45% npv, and TAPSE < 16 mm (sensitivity 93%, specificity 100%).
Conclusion
RV indices (S′ velocity, MPI–TDI and TAPSE) are useful in predicting proximal RCA as infarct related artery in IWMI.
期刊介绍：
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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