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Subject Area

Urology

Article Type

Original Study

Abstract

Objective To asses s right ventricular (RV) function in patients with anterior ST segment elevation myocardial infarction (MI) undergoing primary percutaneous coronary intervention (PCI) by speckle-tracking imaging study. Patients and methods A total of 150 consecutive patients less than 40 years with anterior ST segment elevation MI and have a single left anterior-descending artery disease who underwent successful primary PCI were enrolled in the study. Patients with a history of prior MI, PCI, coronary-artery bypass graft, those who had a bundle-branch block, PCI, coronary-artery bypass graft, those who had a bundle-branch block on baseline ECG, pulmonary hypertension (primary and secondary), primary valvular heart disease, lung disease, cardiomyopathy, systemic illness (renal, hepatic, and malignancy), and bad echogenic window all were excluded. Echocardiography was performed during the hospital stay to assess ventricular function. RV function was assessed by RV fractional area change, tricuspid annular plane systolic excursion, tricuspid annular systolic and diastolic velocities, and two-dimensional-derived strain and strain rate of the RV free wall. Results RV free-wall peak systolic strain, systolic strain rate, and early diastolic strain rate were significantly lower in patient groups (−15.36 ± 2.60 vs. −25.07 ± 1.49, P = 0.006, −1.09 ± 0.18 vs. −1.78 ± 0.10, P = 0.005, and 1.45 ± 0.33 vs. 2.19 ± 0.56 with P = 0.004, respectively). Also, systolic and early diastolic tricuspid annular and early diastolic peak velocities were lowered in patient groups than in controls, in addition, there was no significant difference between both groups regarding RV size, dimension, and fractional area changes. Conclusion RV function in patients with anterior MI is significantly affected even after rapid PCI and recanalization of left anterior-descending in young patients. Strain and strain rate are new, useful imaging techniques for detection of early RV dysfunction in patients with anterior MI.

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