Cardiology and Cardiovascular Research

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Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography

Received: 23 May 2020    Accepted: 18 June 2020    Published: 23 July 2020
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Abstract

Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but RA affection is not fully elucidated in patients with myocardial infarction (MI) Objective: To assess RA function by 2-Dimensional speckle tracking echocardiography (2D-STE) imaging in patients with acute first left ventricular (LV) inferior wall MI with and without RV involvement. Patients & methods:-Sixty patients with acute first inferior MI were included in this study; 30 patients had ECG signs of inferior MI without RV infarction (group II) and 30 patients had ECG signs of inferior MI with RV involvement (group III). Twenty five age and sex -matched healthy volunteers were included as a control group (group I). Assessment of RA function was done in all subjects using (2D-STE) for measurements of RA septal and free walls longitudinal strain and strain rate (SR). Results:-RA septal wall & global systolic strain were significantly reduced in group III (22.5±14.8% and 40.4±24.5%) compared to group I (37.5±16.3% and 60.4±22.4%) and group II (35.7±17.4% and 54.9±25.73%), (P<0.001), (P=0.008) respectively. RA septal wall and global early diastolic strain rate were also significantly reduced in group III (- 0.77±0.46 s-1 and – 3.61±0.55 s-1) compared to group I (-1.38±0.74 s-1 and – 4.41±0.67 s-1) and group II (-1.07±0.76 s-1 and -3.73±0.76 s-1), (P=0.005), (P<0.001) respectively. Conclusion:-In patients with first LV inferior wall MI with RV involvement, RA functional parameters (RA septal and global strain and SR) were significantly impaired in comparison to healthy controls and patients with first LV inferior wall MI without RV affection. This result may illustrate the significant relation between RV & RA which is still under research.

DOI 10.11648/j.ccr.20200403.16
Published in Cardiology and Cardiovascular Research (Volume 4, Issue 3, September 2020)
Page(s) 111-118
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Right Atrium, Inferior MI, Strain, Strain Rate

References
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[2] Kristian T, JS Alpert, Harvey D, White (2007) HDJoint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. Eur Heart J.
[3] Braat SH, Brugada P, de Zwaan C, Coenegracht JM, Wellens HJ. (1983) Value of electrocardiogramin detecting right ventricular involvement in patients with acute inferior wall myocardial infarction. Heart J.
[4] D’Alto M, Scognamiglio G, Dimopoulos K, Bossone E, Vizza D, Romeo E, Vonk-Noordergraaf A, Gaine S, Peacock A, Naeije R (2015) Right heart and pulmonary vessels structure and function.
[5] Dogan C, Ozdemir N, Hatipoglu S, Bakal RB, Omaygenc MO, Dindar B, Candan O, Emiroglu MY, Kaymaz C (2013) Relation of left atrial peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in patients presenting with ST-elevation myocardial infarction.
[6] Jing Z, Jianchang C, Weiting X, Lan G, Shaikh F, Yanni W (2013) Comparison of left atrial function in healthy individuals versus patients with non-ST-segment elevation myocardial infarction using two-dimensional speckle tracking echocardiography. Cardiovasc J Afr.
[7] Elnoamany M, Ahmed N, Ragab E (2014) Echocardiographic assessment of right ventricular function in patients with pulmonary hypertension: strain imaging study. Menoufia Med J.
[8] Monaster S, Ahmad M, Braik A (2014). Comparison between strain and strain rate in hypertensive patients with and without left ventricular hypertrophy: a speckle-tracking study. Menoufia Med J.
[9] Chockalingam A, Gnanavelu G, Alagesan R, Subramaniam T. (2004) Myocardial performance index in evaluation of acute right ventricular myocardial infarction. Echocardiography.
[10] Goldstein JA (2012) Acute right ventricular infarction. Cardiol Clin.
[11] Schiller, N. B., Shah, P. M., Crawford, M., DeMaria, A., Devereux, R., Feigenbaum, H.,… Tajik, A. J. (1989). Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography. Journal of the American Society of Echocardiography, 2 (5), 358–367. doi: 10.1016/s0894-7317(89)80014-8.
[12] Bussadori, C., Moreo, A., Di Donato, M., De Chiara, B., Negura, D., Dall’Aglio, E., Carminati, M. (2009). A new 2D-based method for myocardial velocity strain and strain rate quantification in a normal adult and paediatric population: assessment of reference values. Cardiovascular Ultrasound, 7 (1). doi: 10.1186/1476-7120-7-8.
[13] Nourian, S., Hosseinsabet, A., Jalali, A., & Mohseni-Badalabadi, R. (2016). Evaluation of right atrial function by two-dimensional speckle-tracking echocardiography in patients with right ventricular myocardial infarction. The International Journal of Cardiovascular Imaging, 33 (1), 47–56.
[14] Badran HM, Soltan G, Hassan H, Nazmy A, Faheem N, Saadan H, Yacoub MH. (2012) Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging, Global Cardiology Science & Practice.: 25.
[15] Haghighi, Z. O., Naderi, N., Amin, A., Taghavi, S., Sadeghi, M., Moladoust, H.,… Haghighi, H. O. (2011). Quantitative assessment of right atrial function by strain and strain rate imaging in patients with heart failure. Acta Cardiologica, 66 (6), 737–742. doi: 10.1080/ac.66.6.2136957.
[16] Antoni, M. L., ten Brinke, E. A., Atary, J. Z., Marsan, N. A., Holman, E. R., Schalij, M. J., Delgado, V. (2011). Left atrial strain is related to adverse events in patients after acute myocardial infarction treated with primary percutaneous coronary intervention. Heart, 97 (16), 1332–1337. 2011.
[17] Yan P, Sun B, Shi H, Zhu W, Zhou Q, Jiang Y, Zhu H, Huang G (2012). Left atrial and right atrial deformation in patients with coronary artery disease: a velocity vector imaging-based study. PLoS One 7: e51204.
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Author Information
  • Cardiology Department, Faculty of Medicine, Menoufiya University, Shibin El Koum, Egypt

  • Cardiology Department, Faculty of Medicine, Menoufiya University, Shibin El Koum, Egypt

  • Cardiology Department, Faculty of Medicine, Menoufiya University, Shibin El Koum, Egypt

  • Cardiology Department, Teaching Institutes Organization, Shibin El Koum, Egypt

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    Mohamed Fahmy El-Noamany, Ghada Mahmoud Soltan, Naglaa Fahim Ahmed, Haitham Mohamed Omar El-Ahwal. (2020). Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography. Cardiology and Cardiovascular Research, 4(3), 111-118. https://doi.org/10.11648/j.ccr.20200403.16

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    Mohamed Fahmy El-Noamany; Ghada Mahmoud Soltan; Naglaa Fahim Ahmed; Haitham Mohamed Omar El-Ahwal. Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography. Cardiol. Cardiovasc. Res. 2020, 4(3), 111-118. doi: 10.11648/j.ccr.20200403.16

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    AMA Style

    Mohamed Fahmy El-Noamany, Ghada Mahmoud Soltan, Naglaa Fahim Ahmed, Haitham Mohamed Omar El-Ahwal. Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography. Cardiol Cardiovasc Res. 2020;4(3):111-118. doi: 10.11648/j.ccr.20200403.16

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  • @article{10.11648/j.ccr.20200403.16,
      author = {Mohamed Fahmy El-Noamany and Ghada Mahmoud Soltan and Naglaa Fahim Ahmed and Haitham Mohamed Omar El-Ahwal},
      title = {Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography},
      journal = {Cardiology and Cardiovascular Research},
      volume = {4},
      number = {3},
      pages = {111-118},
      doi = {10.11648/j.ccr.20200403.16},
      url = {https://doi.org/10.11648/j.ccr.20200403.16},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ccr.20200403.16},
      abstract = {Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but RA affection is not fully elucidated in patients with myocardial infarction (MI) Objective: To assess RA function by 2-Dimensional speckle tracking echocardiography (2D-STE) imaging in patients with acute first left ventricular (LV) inferior wall MI with and without RV involvement. Patients & methods:-Sixty patients with acute first inferior MI were included in this study; 30 patients had ECG signs of inferior MI without RV infarction (group II) and 30 patients had ECG signs of inferior MI with RV involvement (group III). Twenty five age and sex -matched healthy volunteers were included as a control group (group I). Assessment of RA function was done in all subjects using (2D-STE) for measurements of RA septal and free walls longitudinal strain and strain rate (SR). Results:-RA septal wall & global systolic strain were significantly reduced in group III (22.5±14.8% and 40.4±24.5%) compared to group I (37.5±16.3% and 60.4±22.4%) and group II (35.7±17.4% and 54.9±25.73%), (P<0.001), (P=0.008) respectively. RA septal wall and global early diastolic strain rate were also significantly reduced in group III (- 0.77±0.46 s-1 and – 3.61±0.55 s-1) compared to group I (-1.38±0.74 s-1 and – 4.41±0.67 s-1) and group II (-1.07±0.76 s-1 and -3.73±0.76 s-1), (P=0.005), (P<0.001) respectively. Conclusion:-In patients with first LV inferior wall MI with RV involvement, RA functional parameters (RA septal and global strain and SR) were significantly impaired in comparison to healthy controls and patients with first LV inferior wall MI without RV affection. This result may illustrate the significant relation between RV & RA which is still under research.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography
    AU  - Mohamed Fahmy El-Noamany
    AU  - Ghada Mahmoud Soltan
    AU  - Naglaa Fahim Ahmed
    AU  - Haitham Mohamed Omar El-Ahwal
    Y1  - 2020/07/23
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ccr.20200403.16
    DO  - 10.11648/j.ccr.20200403.16
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 111
    EP  - 118
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20200403.16
    AB  - Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but RA affection is not fully elucidated in patients with myocardial infarction (MI) Objective: To assess RA function by 2-Dimensional speckle tracking echocardiography (2D-STE) imaging in patients with acute first left ventricular (LV) inferior wall MI with and without RV involvement. Patients & methods:-Sixty patients with acute first inferior MI were included in this study; 30 patients had ECG signs of inferior MI without RV infarction (group II) and 30 patients had ECG signs of inferior MI with RV involvement (group III). Twenty five age and sex -matched healthy volunteers were included as a control group (group I). Assessment of RA function was done in all subjects using (2D-STE) for measurements of RA septal and free walls longitudinal strain and strain rate (SR). Results:-RA septal wall & global systolic strain were significantly reduced in group III (22.5±14.8% and 40.4±24.5%) compared to group I (37.5±16.3% and 60.4±22.4%) and group II (35.7±17.4% and 54.9±25.73%), (P<0.001), (P=0.008) respectively. RA septal wall and global early diastolic strain rate were also significantly reduced in group III (- 0.77±0.46 s-1 and – 3.61±0.55 s-1) compared to group I (-1.38±0.74 s-1 and – 4.41±0.67 s-1) and group II (-1.07±0.76 s-1 and -3.73±0.76 s-1), (P=0.005), (P<0.001) respectively. Conclusion:-In patients with first LV inferior wall MI with RV involvement, RA functional parameters (RA septal and global strain and SR) were significantly impaired in comparison to healthy controls and patients with first LV inferior wall MI without RV affection. This result may illustrate the significant relation between RV & RA which is still under research.
    VL  - 4
    IS  - 3
    ER  - 

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