Role of 2-dimensional speckle tracking echocardiography in diagnosis of right ventricular involvement in patients with inferior wall myocardial infarction undergoing primary percutaneous coronary intervention
AbstractDiagnosis of right ventricular (RV) infarction in the setting of acute inferior wall myocardial infarction (IWMI) has important prognostic implications. We sought to assess the role of 2-D speckle tracking echocardiography (2-D STE) for the assessment of RV involvement in acute IWMI. We included 100 consecutive patients with a diagnosis of recent IWMI, of which 73 had an RCA culprit lesion, undergoing primary percutaneous coronary intervention (PPCI). Patients (n = 73) were classified into 2 groups based on angiographic evidence of RV involvement (lesions proximal to or in volving RV branch versus distal lesions). Echocardiographic features of RV dysfunction were assessed using conventional 2-D echocardiographic, and Tissue Doppler parameters as well as 2-D speckle tracking echocardiography. Out of the 73 patients, 42 had RCA lesion proximal to or involving RV branch , while 31 patients had RCA culprit distal to RV branch. Among different parameters assessing RV function, only RV-FWLS was significantly lower among the former group (− 14.2 ± 4.6 vs. − 17.7 ± 4.2, p = 0.026). Receiver-operator characteristic (ROC) analysis showed that RV-FWLS had the strongest discriminatory capability to identify RV infarction (AUC = 0.7, p = 0.02, 95% CI 0.53–0.78). A cut-off value of RV-FWLS ≤ − 20.5% had 88% sensitivity and 33% specificity f...
J Invasive Cardiol. 2021 Oct;33(10):E836-E838.ABSTRACTA 75-year-old woman with hypertension, hypothyroidism, and diabetes was referred to the catheterization laboratory due to non-ST segment elevation myocardial infarction. Urgent coronary angiography was uneventfully performed via right distal transradial access, despite lusoria subclavian artery. Left anterior descending artery was successfully treated by percutaneous coronary intervention with stenting. A TR band was left in situ for 60 minutes and completely removed after 2 hours, without bleeding. Proximal and distal radial pulses were palpable after hemostasis and at...
CONCLUSION: Using preprocedural variables, we developed and validated a risk model for unplanned postprocedural RRT following ICA and/or PCI.PMID:34605397 | DOI:10.5414/CN110273
ConclusionD-dimer level on admission independently predicts no-reflow after p-PCI. High D-dimer level on admission has an independent prognostic value.
AbstractAimWe aimed to investigate the comparative prognostic value of left ventricular ejection fraction (LVEF), mitral annular plane systolic excursion (MAPSE), fast manual long-axis strain (LAS) and global longitudinal strain (GLS) determined by cardiac magnetic resonance (CMR) in patients after ST-segment elevation myocardial infarction (STEMI).Methods and resultsThis observational cohort study included 445 acute STEMI patients treated with primary percutaneous coronary intervention (pPCI). Comprehensive CMR examinations were performed 3 [interquartile range (IQR): 2 –4] days after pPCI for the determination of l...
ConclusionA minimal-contrast RA approach with IVUS-guidance for treatment of complex calcified coronary lesions is feasible and safe with high success rate.Graphic abstract
ConclusionImpaired RV function in patients presenting with RV infarction can be predicted by different angiographic findings. Proximal RCA total occlusion being commonest IRA associated with impaired RV function. Also, presence of heavy thrombus burden and less than TIMI III flow after angioplasty are associated with increased risk of impaired RV function. RV free wall strain measured by 2D-speckle tracking echocardiography has highest accuracy in detection of proximal RCA occlusion compared to other echocardiographic indices including TAPSE, S ’ and FAC.
CONCLUSION: STEMI is not an uncommon complication among KTR and is associated with significant mechanical complications. Improvement in cardiovascular risk factors might improve the STEMI rates among KTR.PMID:34565688 | DOI:10.1016/j.jjcc.2021.09.006