Evaluation of Right Atrial Function by 2D Speckle Tracking Echocardiography in Patients Undergoing Primary Percutaneous Coronary Intervention after Inferior ST Segment Elevation Myocardial Infarction

Abstract Aim and Objectives The aim of the study is to evaluate right atrial function by 2D speckle tracking echocardiography in patients undergoing primary percutaneous coronary intervention after inferior ST segment elevation myocardial infarction. Patients and Methods This study included 100 patients diagnosed with Inferior STEMI subdivided into patients with RV infarction (26 patients) and those without RV Infarction (74 patients) in the ER fulfilling the inclusion criteria compared to the Control Group (50 patients) of healthy individuals matched in the same age group with no history of acute coronary syndrome and no cardiovascular risk factors, these patients were assessed demographic data, risk factors, general examination, local examination, laboratory measure, ECG and full echocardiographic assessment including 2DSTE evaluation of the RA. Results In our study the results showed that RA strain during reservoir phase (RASr) and RA strain during conduit phase (RAScd) were reduced among the patients with inferior wall MI compared to the control group (P-value: <0.001), While RA strain during contractile phase (RASct) was preserved among the patients group (P-value: <0.001), Also RA total emptying fraction (RA EF) and RA total emptying volume (RA EV) were preserved among the patients group compared to the control group (P-value: 0.095, 0.062 respectively). Then we compared the patients with inferior wall myocardial infarction with RV infarction to the patients with no RV infarction, The results showed that RA strain during reservoir, conduit and contractile phases were preserved among the patients with RV infarction compared to those without RV infarction (P-value: 0.196, 0.118, 0.266 respectively), While RA EF and RA EV were significantly reduced among the patients with RV infarction compared to those without RV infarction (P-value: 0.029, 0.038 respectively), There was a positive correlation between RA EF with RV functions parameters as TAPSE (r: 0.377, P-value: <0.001), FAC (r: 0.425, P-value: <0.001), Also There was a positive correlation between RA EV with RV functions parameters as TAPSE (r: 0.239, P-value: 0.017), FAC (r: 0.378 P-value: <0.001) Conclusion RA strain during reservoir phase (RASr) and RA strain during conduit phase (RAScd) were significantly lower in patients with inferior wall myocardial infarction compared to the control group, while RA strain during contractile phase (RASct),RA Emptying Fraction (RA EF) and RA Emptying Volume were preserved among the patients with inferior wall myorcardial infarction compared to control group. Patients with inferior wall myocardial infarction with RV infarction have lower RA emptying fraction (RA EF) and RA emptying volume than those without RV infarction.