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Two-dimensional (2D) strain and strain rate (SR) analyses are novel Doppler-independent techniques to assess myocardial deformation. While this method has been frequently used to assess LV function, it has yet rarely been used to examine right ventricular (RV) function.
This is a prospective study, Forty patients with acute inferior & right MI were included in this study, based on the ECG criteria, All Patients received thrombolytic therapy within 6 hours from chest pain onset, coronary angiography was done within the first 24 hours from admission and TIMI flow grade in RCA was determined and recorded for each patient, Echocardiography was performed before coronary angiography using a Vivid 9 (GE Vingmed, Norway). For speckle tracking analysis of the RV, two-dimensional apical four-chamber views were acquired over three cardiac cycles during a breath hold with the frame rate set between 60-80 frames per second. Measurement of the RV TAPSE, RVFAC, EPASP, RV TDI -St was done in accordance with current American Society of Echocardiography recommendations, Measurement of RV free wall strain & SR was performed offline on a PC workstation using custom analysis software (Echopac PC, Version1.8.1.X, GE), The data were collected and statistically analyzed by SPSS statistical package (SPSS V17).
Positive significant correlation between TIMI flow grade in the RCA and the cumulative systolic strain rate SRs s-1 (pvalue<0.001) and (rvalue=0.48). There was no statistically significant correlation between the other echocardiographic RV parameters and the TIMI flow grade of the RCA (pvalue<0.05). (Table 1)
The RV free wall cumulative strain rate (SRs s-1) can predict the TIMI flow grade in the RCA in patients with acute RV infarction. Thus it can help determining successfulness of the thrombolytic therapy in those group of patients.