Automatic backscatter analysis of regional right ventricular systolic function using colour kinesis in patients with inferior wall acute myocardial infarction with or without right ventricular involvement

BACKGROUND: In patients with inferior acute myocardial infarction (AMI), right ventricular (RV) function is an important determinant of global cardiac performance, prognosis, and exercise capacity. Several echocardiographic methods for quantifying RV function have been developed over the years but the usefulness of colour kinesis (CK) and acoustic quantification (AQ) have not yet been investigated. AIM: To test whether AQ and CK may provide quantitative assessment of global and regional RV function in patients with inferior AMI. METHODS: Thirty two consecutive patients with recent inferior AMI with or without RV involvement (n=17 and n=15, respectively), and 15 age- and gender-matched controls were studied. The graphs of RV fractional area change were displayed along with ECG and the concurrent cross sectional image. CK digitised end-systolic images of RV and were evaluated by reviewing the stored loops obtained from normal subjects and patients. To evaluate the entire RV systolic endocardial excursion, further quantitative CK analysis was performed by measuring the systolic segmental endocardial motion (SEM). RESULTS: In comparison with the control group, patients with inferior AMI with or without RV involvement had reduced RV fractional area change (30+/-7%, 36+/-6%,45+/-6%, p<0.05, p<0.01 respectively), reduced mean free wall SEM (3.9+/-1.1 mm, 5.2+/-1.3 mm, 6.3+/-1.4 mm, p<0.05, p<0.01 respectively) and mean septal wall SEM (4.9+/-1.2 mm, 6.4+/-1.5 mm, 7.2+/-1.4 mm, p<0.05, p<0.05, respectively). CONCLUSIONS: Our results confirmed that RV systolic functions are significantly more altered in patients with inferior AMI than in controls, and that RV abnormalities are more pronounced in patients with rather than without RV involvement. AQ and CK are able to detect wall motion disturbances in patients with inferior AMI with RV involvement.