Currently submitted to: JMIR Cardio
Date Submitted: Nov 27, 2019
Open Peer Review Period: Nov 27, 2019 - Jan 22, 2020
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Echocardiographic assessment of right ventricular functions in patients with acute myocardial infarction: A 2 year Prospective observational study from North India
A prospective observational study entitled “Assessment of right ventricular functions in patients with acute myocardial infarction-An observational study” was conducted from June 2015 to May 2017 in the Department of Cardiology, National Heart Institute, New Delhi, which is a 100 bedded state of art cardiology center staffed by full-time cardiology team with supportive critical team staff. The study was conducted after approval from local ethical committee after securing informed consent from patients or attendants for participation in the study.
Assessment of right ventricular functions in patients with acute myocardial infarction. To investigate the effect of different infarction sites on right ventricular (RV) functional changes in patients with a first acute myocardial infarction without concomitant RV infarction. To compare RV functions in STEMI VS NSTEMI.
METHODOLOGY: DESIGN: All patients after proper history were admitted in ICCU with proper informed consent taken & subjected to evaluation& management: Hemogram, Renal Function, Lipid profile, X-Ray imaging, Electrocardiogram Cardiac enzymes (Trop-T, CPK, CPK-MB) Echocardiography at presentation and at discharge Patients were revaluated at the time of discharge for RV functions as on presentation by echocardiography. Echocardiography: Study was performed on- echocardiography equipment Phillips CX-50 with Doppler tissue imaging technology, S 5-1 MHz phased array transducer with operating frequency 2-4MHz. Sample volume of 2-4mm was used. Nyquist limit set at 20-60cm/sec was used. A total of 100 patients who match our inclusion criteria were studied from June 2015 to May 2017.
A total of 100 patients of acute myocardial infarction were studied with 73% STEMI & 27% NSTEMI & among these 68% were anterior wall MI (AWMI) & 32% inferior wal MI (IWMI). Prevalence of different risk factors observed in study population was as follows: Dyslipidaemia in 68% patients, diabetes mellitus 64%, hypertension was present in 54%, Family history of coronary artery disease (CAD) was present in 43 % of patients & Smoking was prevalent in 27 % of cases. The present study demonstrated presence of RV dysfunction assessed by echocardiography, in acute MI (STEMI/NSTEMI) irrespective of infarction location and was more commonly seen in AWMI than IWMI.
he present study demonstrates presence of RV dysfunction assessed by echocardiography (RVEDD (RV end diastolic diameter), TAPSE (transannular plane systolic excursion), FAC (Fractional area change), E/E`, RV MPI (Myocardial performance index) by TDI (tissue Doppler imaging)), in acute MI (STEMI/NSTEMI) irrespective of infarction location and was more commonly seen in AWMI than IWMI. This study demonstrated presence of RV dysfunction in acute MI more so in STEMI than NSTEMI.
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