الفهرس 
Acute ST Elevation Myocardial InfarctionOnly 14 pages are availabe for public view
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Abstract
The right ventricle infarction (RVI) may complicate 40 to 50% of inferior myocardial infarction (137).
It is well understood that electrocardiographic evidence of RV infarction is associated with a poor prognosis
Two-dimensional (2D) strain and SR analyses are novel Doppler-independent techniques to obtain these measurements of myocardial movement and deformation, While this method has been frequently used to assess LV function .It has yet rarely been used to examine RV function(138).
The purpose of this study was to evaluate right ventricle during an inferior myocardial infarction with or without right ventricular infarction.
This study was designed to evaluate RV systolic and diastolic functions in 1st attack inferior MI with or with out RV myocardial infarction using strain and strain rate imaging and correlation with SWM score index. 60 individuals were enrolled, divided into three groups; group I (Control group): included 20 healthy ages and sex matched volunteers free from cardiovascular risk factors. Group II: included 20 inferior myocardial patients without RV MI .Group III: included 20 inferior myocardial patients with RV MI .
A right ventricle infarction was defined by an ST elevation of 1 mm or more in right leads (V3R, V4R). All patients underwent Doppler echocardiography during the first 24hours and were compared to healthy subjects
Participants in the study were subjected to full history taking, thorough clinical examination, 12 leads ECG
2D echocardiography, M-mode and Doppler examination were performed; LV dimensions were measured including LVEDD, LVESD, IVSD, LVPWD, LVMI and left ventricular ejection fraction. Pulsed-wave Doppler echocardiography was performed for measuring mitral inflow velocities. Mitral annular TDI was performed in the septal, lateral, anterior and inferior mitral annuli, RVFAC , TAPSI , Tricuspid annular TDI were performed ,Strain and strain rate values were measured to RV free wall , septal and inferior wall
Results of the current study showed that:
Demographic and clinical data
Age:
the mean age for group I (control group) was 50.5 ± 6.0years,the mean age for groupII (Inferior MI without RT MI) was 51.6 ± 5.1years and the mean age for groupIII (Inferior MI with RT MI) was 52.2 ± 6.0years. There was no statistical significant difference between the 3 groups (I, II& III) as regard age(p-value > 0.05).
clinical data:
There was highly significant difference between the three groups as regard DM, HTN, and smoking (p- value: 0.01) . LV Echocardiography:
No significant differences between the three studied groups regarding LV ejection fraction .
A highly significant difference was present between group III (Inferior MI with RT MI), group II (Inferior MI without RT MI) and group I (control) as regard IVSD, LVPWD and left atrium dimension (P-value < 0.001 = highly significant)
Comparing group III (Inferior MI with RT MI) with group I (control) and group II (Inferior MI with out RT MI) a highly significant difference was present as regard LV mass and LV mass index (P1-value < 0.001)
A statistically highly significant difference was found among the three groups regarding SWMSI (P-value < 0.001)
the right ventricular assessment:
A statistically highly significant difference was found among the three groups regarding TAPSE (P-value < 0.001)
A statistically highly significant difference was found among the three groups regarding RV FAC (P-value < 0.001)
A statistically highly significant difference was found among the three groups regarding The St velocities & Et peak velocities (P-value < 0.001)
the Right ventricular systolic function as assessed by strain and strain rate
A statistically significant difference was found among the three groups regarding The Peak systolic longitudinal strain (P-value < 0.05) A statistically significant difference was found among the three groups regarding The Peak Systolic strain rate at basal & mid segment (P-value < 0.05)
No significant difference was present between three groups regarding The Peak systolic strain rate at apical segment (P-value <0.05)
A statistically significant difference was found among the three groups regarding early diastolic Strain Rate (SRe s-1) at basal & mid segment (P-value < 0.05) ,while no significant difference was found among the three groups regarding The early diastolic Strain Rate (SRe s-1) at apical segment (P-value <0.05)
Correlation between cumulative Peak systolic longitudinal strain Esys % RV free wall and cumulative Peak systolic longitudinal strain Esys % inferior wall
Positive significant correlation between cumulative Peak systolic longitudinal strain Esys % Inferior wall and cumulative Peak systolic longitudinal strain Esys % RV free wall (pvalue<0.05)and(rvalue=-0.34).
Correlation between TIMI flow coronary angiography and right ventricle assessment parameters
Positive significant correlation between TIMI flow coronary angiography and cumulative systolic strain rate SRs s-1 (pvalue<0.05)and(rvalue=-0.48).
No significant correlation between TIMI flow coronary angiography and right ventricle other assessment parameters (pvalue<0.05). the correlation between SWM score index and other parameters
No significant difference was present between three groups regarding The Peak systolic strain rate at apical segment (P-value <0.05) 2. Negative significant correlation between TAPSE and SWMSI (pvalue <0.05) and (rvalue=-0.30).
No significant correlation between RVFAC and SWMSI (pvalue <0.05) and (rvalue=-0.24).
Positive significant correlation between EPASP and SWMSI (pvalue <0.05) and (rvalue= 0.33).
Negative significant correlation between RV free wall strain (basal , mid , apical ) and SWMSI (pvalue <0.05) and (rvalue=-0.33 ,-0.39,-0.32).
Negative significant correlation between RV free wall SRs s-1 (basal , mid , apical.