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[Assessment of right ventricular function using contrast echocardiography in patients with myocardial infarction]
Gabriela Borrayo1, Guillermo Careaga, Carlos J Muro
1Unidad de Cuidados Intensivos Coronarios, Hospital de Cardiología Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México. gborrayos@hotmail.com.mx
Objective:
To evaluate right ventricular size, motility, and ejection fraction (RVEF) by contrast echocardiography.
Methods:
We studied consecutive patients admitted to the coronary intensive care unit with acute inferior myocardial infarction, without prior infarction and with or without right ventricle involvement, according to accepted electrocardiographic findings. Polygelin, 3.5% solution, was used for contrast echocardiography. The reference standard was equilibrium radionuclide angiography.
Results:
We studied 44 patients using contrast echocardiography, average patient age 60.8 +/- 10.6 years, 38 men and 6 women. Abnormal right ventricular size (more than 25 mm) yielded a sensitivity of 79%, specificity of 87%, positive and negative predictive values of 92 and 68%, respectively, and a likelihood ratio of 6. Abnormal right ventricular motility had a sensitivity of 70%, specificity of 94%, positive and negative predictive values of 95 and 67%, respectively, and a likelihood ratio of 11.6. Right ventricular ejection fraction < 30% with contrast echocardiography had a sensitivity of 69%, specificity of 97%, positive and negative predictive values of 90 and 88% respectively, and a likelihood ratio of 6.9.
Conclusion:
In patients with acute inferior myocardial infarction, contrast echocardiography with the area-length method is a valid and reproducible technique for evaluating right ventricular ejection fraction, which is easy to perform and can be done at the patient's bedside.