F-24 | Comparative Assessment of Left Ventricular Function: Invasive Ventriculography Versus Transthoracic Echocardiography within One Month: A Single-Center Experience

Background: This study aimed to evaluate right ventricular (RV) function as a predictor of proximal right coronary artery (RCA) stenosis and to identify high-risk patients with inferior wall myocardial infarction (IWMI) using echocardiographic parameters.Methods: This two-arm, single-center cross-sectional study analyzed 67 patients presenting with their first episode of acute IWMI within 24 h of symptom.Echocardiographic parameters, including tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity (S'), and myocardial performance index (MPI), were measured.All patients underwent coronary angiography or intervention within 1 month.Based on angiographic findings, patients were classified into Group A (significant proximal RCA stenosis; n25) and Group B (without significant proximal RCA stenosis; n42).Results: RV involvement was significantly higher among patients with proximal RCA stenosis.Group A exhibited significantly lower SBP, DBP, and heart rate, as well as elevated JVP, NT-pro BNP, and Trop-I levels.Group A patients demonstrated higher ST elevation in lead V4R, RV diastolic dysfunction, arrhythmias, and higher rates of intervention.Additionally, group-A patients had significantly reduced TAPSE (measured by M-mode), early tricuspid inflow time by pulsed-wave (ET-PW), early diastolic velocity by tissue Doppler imaging (ET by TDI), S', E', and RV fractional area change, as well as increased MPI by PW, isovolumic relaxation time by TDI (IRT by TDI), isovolumic contraction time by TDI (ICT by TDI), and MPI by TDI on echocardiography.The sensitivity to detect proximal RCA stenosis was 92% for TAPSE-M mode, 88% for MPI by TDI, and 100% specificity for S' by TDI < 10 cm/s, MPI by TDI, and ST elevation in V4R.Conclusions: Echocardiographic assessment of RV parameters, including TAPSE, S' velocity, and MPI, is valuable for predicting proximal RCA as the culprit lesion in IWMI.Patients with proximal RCA stenosis demonstrated elevated JVP, NT-proBNP, and troponin I levels, ST elevation in lead V4R, RV diastolic dysfunction, and arrhythmias and were more likely to undergo intervention.