P1477Right atrial and ventricular function assessed by speckle tracking in patients with inferior wall myocardial infarction

• Published in: European heart journal Vol. 40; no. Supplement_1
• Main Authors: Gonzalez-Velasquez, P, Gopar-Nieto, R, Flores-Garcia, A, Alexanderson-Rosas, E, Espinola-Zavaleta, N
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.10.2019
• Subjects: Tissue Doppler, Speckle Tracking and Strain Imaging
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehz748.0242

Abstract Background Right chambers involvement in left ventricular inferior wall myocardial infarction (LVIWMI) has a prognostic impact. Purpose To evaluate the influence of LVIWMI in right atrium (RA) and right ventricular (RV) mechanics. Methods We included 60 consecutive patients who underwent myocardial perfusion (MP) gated-SPECT for chest pain. We identify 30 patients with LVIWMI and 30 control individuals with normal MP. Comprehensive echocardiography was performed in all patients. RV free wall longitudinal strain (RVFWLS) and RA reservoir (RAr), contraction (RAct) and conduit (RAcd) phase strain were analyzed by 2D speckle tracking echocardiography (STE). Results RVFWLS (−26.1 vs 30.3, p<0.01), RAr (peak strain) (31.5 vs 56.2, p<0.01) and RAcd strain (12.5 vs 35, p=0.01) were significantly lower in the LVIWMI patients vs control individuals. In a logistic regression model, LVIWMI, reduced 3D LV and RV ejection fraction, mitral regurgitation and pulmonary hypertension were associated with reduction in RV an RA strain. Echocardiographic parameters LV inferior wall MI patients (n=30) Control subjects (n=30) p value 3D LV EDV (ml) (median, IQR) 121 (99.7–150) 89.5 (73–99) <0.01 3D LV EF (%) (median, IQR) 46 (37–53) 60 (58–63) <0.01 Mitral E/A (median, IQR) 0.82 (0.7–1.2) 1.21 (0.97–1.44) <0.01 Medial E/e' (median, IQR) 9.59 (7.9–13) 7.7 (6.9–10.5) 0.01 RV EDD (mm) (mean, SD) 36.7±7.4 34.7±4.39 0.12 TAPSE (mm) (mean, SD) 18.6±5.05 21.7±4.1 <0.01 RV FAC (%) (mean, SD) 37±9 46.8±7.24 <0.01 RV S' (cm/s) (mean, SD) 9.9±2.7 11.8±1.85 <0.01 3D RV EF (%) (median, IQR) 47.5 (42–52) 54 (49–57) <0.01 RIMP (mean, SD) 0.49±0.2 0.46±0.12 0.60 SPAP (mmHg) (median, IQR) 31.5 (27–37) 29.5 (26–33) 0.07 Peak global LV LS (%) (median IQR) −13.35 (−17.6–9.3) −22 (−23.2–20.4) <0.01 RV free wall LS (%) (median, IQR) −26.1 (−32.1–17.8) −30.3 (−36.6–27.5) <0.01 RA peak strain (reservoir phase) (%) (median, IQR) 31.5 (25.2–43) 56.2 (47–66.4) <0.01 RA contraction phase strain (%) (mean, SD) 20.17±10.4 24.4±10.36 0.07 RA conduit phase strain (%) (median, IQR) 12.5 (5.9–15.6) 35 (21–47.6) 0.01 Normal RVFW (A) and RA strain (B) Conclusion STE is a feasible technique for assessment of RVFW and RA deformation. Subclinical extension to RV in LVIWMI and its influence in RA mechanics could be assess by 2D-STE.