Document Type : Original Article
Authors
1
Assistant professor of Cardiology Department, Faculty of Medicine, Zagazig University, Egypt
2
Professor of Cardiology Department, Faculty of Medicine, Zagazig University, Egypt.
3
Department of Cardiology, El-Ahrar Teaching Hospital, Zagazig, Egypt
4
Lecturer of Cardiology Department, Faculty of Medicine, Zagazig University, Egypt.
Abstract
Background: Adverse outcomes are more likely to occur in patients with right ventricular infarction who present with inferior ST-elevation myocardial infarction (STEMI). In order to identify patients who may have RV dysfunction earlier, the aim of this study is to determine a relationship between the culprit artery in inferior STEMI and tricuspid annular plane systolic excursion (TAPSE). Methods: In this prospective cohort study, 200 patients who presented for the first time with acute inferior STEMI were included. Three groups of patients were formed according to which coronary artery was the culprit. At admission and following revascularization, RV function was evaluated using various echocardiographic measures, including TAPSE, RV-FAC, pulsed wave tissue Doppler imaging indices such as E′, A′, S′, MPI, and RV diastolic dysfunction. Results: At a threshold level of >15, baseline TAPSE can be utilized to distinguish inferior STEMI culprit vessel between LCX and RCA patients. In RCA patients, there was a substantial statistically significant change (p-value<0.001) in S′, TAPSE, ICT, IRT, and MPI between baseline and pre-discharge. However, from baseline until the time of discharge, there was no statistically significant difference (p-value>0.05) in the E′, A′, RVFAC, ET, and LVEF of the RCA patients. Conclusion: At a cutoff level of >15, baseline TAPSE can be used to suggest RCA patients from LCX patients as the cause of inferior STEMI. RV diastolic and systolic performances improved as a result of revascularization. In general, the prognosis for an RCA-related infarction is poorer than that of an LCX-related infarction.
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