Role of Speckle Tracking in Detection and Short Term Follow Up of Right Ventricular Systolic Dysfunction in Patients with Acute Inferior STEMI

Abstract Background The right ventricle (RV) is a thin-walled chamber characterized by functioning under low oxygen demands and pressure. RV is perfused throughout the cardiac cycle in both systole and diastole. These factors make RV less susceptible to infarction compared to the left ventricle. Successful primary PCI in patients with RV infarction has shown to regain the RV systolic function and is associated with better in-hospital morbidity and mortality. Speckle tracking derived strain provides accurate assessment of the RV global and segmental myocardial function. Objective To assess RV systolic function in inferior STEMI using 2D echocardiography speckle tracking derived longitudinal strain early after primary PCI and follow up 3 months later. Methods This prospective cohort study was conducted at Ain Shams University Hospitals. 50 patients underwent successful (PCI) after inferior STEMI. Another 50 healthy individuals were examined “to obtain reference values for RV FWS”. Results RV function parameters showed good prognosis 3 months after primary PCI: TAPSE (39 patients “78%” showed improvement Vs 11 “22%” that had no change), also Fractional area change (FAC) (42 patients “84 %” improved Vs 8 non improved patients “16%”) finally Free wall strain showed the better improvement (44 patients “88 %” improved). Conclusion Among the echo Doppler parameters, FAC and. RV speckle tracking derived strain parameters were the most sensitive in assessment of RV function impairment and recovery after inferior STEMI.