الفهرس | Only 14 pages are availabe for public view |
Abstract Myocardial infarction (MI) is a major cause of death and disability worldwide. Coronary atherosclerosis is a chronic disease with stable and unstable periods. During unstable periods with activated inflammation in the vascular wall, patients may develop a MI. MI may be a minor event in a lifelong chronic disease; it may even go undetected, but it may also be a major catastrophic event leading to sudden death or severe hemodynamic deterioration. Acute MI may be the first manifestation of coronary artery disease, or it may occur repeatedly in patients with established disease. Right ventricular functions are affected in about one-third of the patients by the inferior myocardial infarction (MI), as the most important limitations, echocardiographic parameters evaluated with TDI are angledependent and influenced by myocardial tethering effect. The involvement of the right ventricle (RV) has been defined as a strong predictor of major complications and in-hospital mortality in patients with acute inferior myocardial infarction (MI). Despite the current large-scale use of primary percutaneous coronary intervention (PCI), RV dysfunction after acute MI remains common and associated with worse prognosis. The Interest in evaluation of the right ventricular dimensions and function has increased recently. With the rapid growing of the new echocardiographic techniques and technology, there has been a corresponding increase in the ability to evaluate the RV, both qualitatively and quantitatively. The main aim of the study: The main aim of this study was to assess the RV mechanics to detect changes in RV structure and function by speckle tracking echocardiography in the patients with acute inferior MI and patients with chronic coronary artery disease involving right coronary artery. Methods: This observational cohort study was conducted at Menoufia University hospital. This study was conducted on 100 patients. All patients were divided into 2 groups: group 1: patients with acute inferior myocardial infarction and coronary angiography shows right coronary lesion. group 2: patients with chronic coronary artery disease and coronary angiography shows significant right coronary lesion. The main results of the study showed that: We found no significant difference between the two studied groups regarding age, sex and BMI. Hypertension was more prevalent comorbid in both groups. Moreover, there is no significant difference was found between the studied groups regarding studied comorbidities. There is no significant difference between the two studied groups regarding heart rate, SBP, and DBP. There is no significant difference between the two groups regarding EF. Mitral, tricuspid E/A ratio and estimated PASP. There is a significant difference between the two groups regarding RV basal dimension, RV FAC, TAPSE, RVFWLS (basal, mid, and apical) and RVGLS. RV FAC, TAPSE are significantly lower in acute inferior MI group than CCS group (P value <0.001). RVFWLS, RVGLS are significantly lower (less negative value) in acute inferior MI group than CCS group (P value 0.031) (P value 0.005) respectively. |