Niniek Purwaningtyas



Right ventricular (RV) involvement increases mortality and morbidity in inferior myocardial infarction (MI). There are sparse data on the usefulness of pulsed tissue Doppler imaging (TDI) in the diagnosis of RV dysfunction in ST segment elevation MI (STEMI). This study evaluate the diagnostic and prognostic significance of RV systolic and diastolic function compared to classical electrocardiographic RVMI diagnostic criteria in this group of patients. Consecutive patients with first, acute, inferior STEMI were prospectively assessed. The RVMI was defined as an ST-segment elevation ≥ 0.1 mV in lead V4R. Echocardiography with TDI was performed within

24 h of the onset of symptoms. Out of 31 patients (mean age 56.39 ± 9.02 years), RVMI was found in 18 (37%). Multivariate analysis showed that two variables—RV systolic and diastolic function, were independent predictors of in-hospital prognosis. Sensitivity and specificity the RV systolic function were 94,4% and 69,2%, respectively. While RV diastolic function were 44% and 76,9%, respectively. RV systolic function predict ECG diagnosis of RVMI with relatively high sensitivity and specificity. RV diastolic function predict ECG diagnosis of RVMI with relatively low sensitivity but with high specificity.

Keywords: tissue Doppler imaging, RV myocardial infarction, inferior myocardial infarction

Full Text:



Bowers TR, O’Neill WW, Pica M, et al. 2002. Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction. Circulation, 106: 1104–1109.

Goldstein J. 2002. Pathophysiology and Management of Right Heart Ischaemia. J Am Coll Cardiol, 40: 841–853.

Hsiao SH, Chiou KR, Huang WC et al. 2010. Right Ventricular Infarction and Tissue Doppler Imaging: Insights from Acute Inferior Myocardial Infarction after Primary Coronary Intervention. Circ J, 74: 2173–2180.

Kukla P, Dudek D, Rakowski T, et al. 2006. Inferior Wall Myocardial Infarction With or Without Right Ventricular Involvement—Treatment and in-Hospital Course. Kardiol Pol, 64: 583–588.

Meluzin J, Spinarova L, Bakala J, et al. 2001. Pulsed Doppler Tissue Imaging of the Velocity of Tricuspid Annular Systolic Motion. A New, Rapid, and Non-invasive Method of Evaluating Right Ventricular Systolic Function. Eur Heart J, 22: 340–348.

Meluzín J, Spinarova L, Dusek L, et al. 2003. Prognostic Importance of the Right Ventricular Function Assessed by Doppler Tissue Imaging. Eur J Echocardiogr, 4: 262–271.

Meluzin J, Spinarova L, Hude P, et al. 2005. Prognostic Importance of Various Echocardiographic Right Ventricular Functional Parameters in Patients with Symptomatic Heart Failure. J Am Soc Echocardiogr, 18: 435–444.

Piestrzeniewicz K, Łuczak K, Piechowiak M, et al. 2006. The Value of Doppler-derived Myocardial Performance Index and Tricuspid Annular Motion in the Evaluation of Right Ventricular Function in Patients with Acute Inferior Myocardial Infarction. Folia Cardiol, 13: 369–378.

Rudski LG, Wyman WL, Afilalo J, et al. 2010. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: a report from the American Society of Echocardiography Endorsed by the EuropeanAssociation of Echocardiography and the Canadian Society of Echocardiography. J Am Soc Echocardiogr, 23: 685–713.

Thygesen K and Alpert JS. 2007. White HD; On Behalf of the Joint esc/accf/whf Task Force for the Redefinition of Myocardial Infarction: Universal Definition of Myocardial Infarction. Eur Heart J, 28: 2525–2538.

Ueti OM, Camargo EE, Ueti Ade A, et al. 2002. Assessment of Right Ventricular Function with Doppler Echocardiographic Indices Derived from Tricuspid Annular Motion: Comparison with Radionuclide Angiography. Heart, 88: 244–248.

Van de Werf F, Ardissino D, Betriu A, et al. 2003. Management of Acute Myocardial Infarction in Patients Presenting with ST-segment Elevation. The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J, 24: 28–66.

Article Metrics

Abstract view(s): 221 time(s)
PDF: 174 time(s)


  • There are currently no refbacks.