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Pulsed Doppler tissue imaging can help to identify patients with right ventricular infarction
Mustafa Yilmaz1, Mustafa Kemal Erol, Mahmut Acikel
1Department of Cardiology, Medical School Hospital, Ataturk University, 25050 Erzurum, Turkey. kardiyomustafa@hotmail.com
Abstract:
This study was planned to assess whether tissue Doppler imaging is a useful method for the detection of the right ventricular myocardial infarction. Forty-eight patients with acute inferior myocardial infarction and 24 age- and sex-matched healthy controls were included in this study. Twenty-four patients had electrocardiographic signs of inferior myocardial infarction without right ventricular infarction (group I), and the other 24 patients had electrocardiographic signs of inferior myocardial infarction with right ventricular infarction (group II). From the echocardiographic apical four-chamber view, peak systolic, early diastolic, and late diastolic velocities of the tricuspid annulus at the right ventricular free wall were recorded with the use of pulsed-wave Doppler tissue imaging. The tricuspid annular peak tissue Doppler imaging systolic velocity was significantly lower in group I (14.03 +/- 2.57 cm/s, P << 0.005) and in group II (8.50 +/- 0.84 cm/s, P << 0.005) than in controls (16.63 +/- 2.31 cm/s). The tricuspid annular peak systolic (8.50 +/- 0.84 cm/s vs 16.63 +/- 2.31 cm/s) and peak early diastolic (10.99 +/- 3.28 cm/s vs 19.39 +/- 4.3 cm/s) velocities were significantly lower in group II than in group I, as compared with controls ( P << 0.001). Peak early diastolic velocity of tricuspid annulus (10.99 +/- 3.28 cm/s vs 19.39 +/- 4.3 cm/s) was significantly lower in group I than in controls ( P << 0.001); however, late diastolic velocity was significantly lower in group II (15.98 +/- 5.08 cm/s, P << 0.05) than in group I (18.21 +/- 2.63 cm/s, P << 0.05) and in controls (19.02 +/- 5.29 cm/s). The results of this study indicate that tricuspid annular peak systolic and early diastolic velocities are reduced in patients with right ventricular infarction. The velocity of the tricuspid annulus by tissue Doppler imaging is simple and can be used to distinguish whether patients with inferior myocardial infarction have right ventricular infarction.