Prognostic Significance of Right Ventricular Global Longitudinal Strain in Acute Myocardial Infarction and Angiographic Correlation

OBJECTIVESObjectives of this study were to evaluate right ventricular function using two dimensional speckle tracking echocardiography among patients who were admitted with acute myocardial infarction and treated with primary angioplasty, association between right ventricular strain global longitudinal strain and major adverse cardiovascular events and to analyse the angiographic results of all patients. METHODSThis was a prospective observational study conducted in 200 consecutive patients admitted with acute inferior wall myocardial infarction and treated with primary angioplasty. Right ventricular global longitudinal strain was measured by two dimensional speckle tracking echocardiography and angiographic results of all patients were recorded. All patients were followed up till discharge / death. Categorical data were compared using Chi-square test or Fisher’s exact test. Logistic regression was done to find out the major adverse cardiovascular outcomes predictive by RVGLS. P < 0.05 was considered statistically significant. RESULTS200 patients were enrolled for the study of which were 102 (51%) patients and 98 (49 %) patients were males and females respectively. Patients with low RVGLS had higher incidence of left ventricular dysfunction(P=0..006) ,low TAPSE and S’(P<0.001) ,angiographic triple vessel disease(p<0.001),arrhythmias(p=0.02) ,right heart failure(P<0.001),target lesion revascularisation(P=0.029) and prolonged hospital stay(P<0.001).In multivariate analysis , arrhythmias (P=0.046 ,OR - 2.05, CI 0.93-8.10) ad target lesion revascularisation were the two major adverse cardiovascular events predictive by RVGLS. CONCLUSIONRVGLS could be used a prognostic marker in patients admitted with acute inferior wall infarction, categorise the risk and might assist the interventionist in planning an earliest therapeutic strategy.