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Quantitative assessment of RV function is still challenging due to its complex anatomy. 2D strain and SR analyses are novel Doppler-independent techniques to obtain measurements of myocardial movement and deformation. These methods have been frequently used to assess LV function, however they have yet rarely been used to examine RV function, despite RV function is an important prognostic factor in patients with acute inferior MI.
A 40 patients with acute inferior MI were included in this study,20 patients had ECG signs of inferior MI without RV infarction (group II) and 20 patients had ECG signs of inferior MI with RV infarction (group III), All Patients received thrombolytic therapy within 6 hours from chest pain , Echocardiography Within 1st 24 hours from admission was performed using a Vivid 9 (GE Vingmed, Norway) equipped with a harmonic M5S transducer , using 2D speckle tracking measurements of RV free wall longitudinal strain and strain rate in the apical four-chamber. ,Image analysis was performed offline on a PC workstation using custom analysis software (Echopac PC, Version1.8.1.X, GE) , 20 volunteers were included as a control (group I). The data collected and statistically analyzed by SPSS statistical package (SPSS V17).
A statistically highly significant difference was found among the three groups regarding the peak systolic longitudinal strain at apical, mid, and basal segments of RV free wall (p < 0.0001)and significant difference was found among the three groups regarding The peak systolic SR at basal and mid segments of RV free wall (p < 0.05).
The findings of this research indicated that RV systolic function was low in both inferior MI groups as evidenced by the highly significant reduction of RV strain rate in inferior MI with RV MI (group III) and without RV MI (group II) with more reduction in group III.
|Rt. Free wall strain (%)||Group I||Group II||Group III||ANOVAF||ANOVAP-value||Tuky's testP1 : between group I & II||Tuky's testP2:between group I & III||Tuky's testP3: between group II & III|
|Apical||Mean±SD||-22.66 ± 1.13||-25.55 ± 8.12||-15.88 ± 8.88||10.5||0.001||0.7||0.001||0.001|
|Mid||Mean±SD||-22.17 ± 1.54||-23.35 ± 6.29||-14.57 ± 6.08||16.9||0.001||0.6||0.001||0.001|
|Basal||Mean±SD||-21.25 ± 1.08||-22.55 ± 7.94||-12.51 ± 5.38||20.5||0.001||0.6||0.001||0.001|
|cumulative||Mean±SD||-22.03 ± 8.6||-23.8 ± 4.7||-14.3 ± 3.9||11.5||0.001||0.8||0.001||0.001|
|Rt. Free wallstrain rate S s-1|
|Apical||Mean±SD||-1.46 ± 0.38||-1.87 ± 0.68||-1.70 ± 0.72||2.25||0.11||0.1||0.04||0.65|
|Mid||Mean±SD||-1.38 ± 0.19||-1.66 ± 0.41||-1.30 ± 0.32||7.2||0.001||0.02||0.04||0.001|
|Basal||Mean±SD||-1.34 ± 0.20||-1.61 ± 0.42||-1.25 ± 0.34||6.95||0.001||0.03||0.04||0.001|