Tissue Doppler systolic annular velocity and myocardial performance index as predictors of right ventricular affection and culprit lesion location in acute inferior myocardial infarction

AimThis study aims at using peak lateral tricuspid annular systolic velocity (S_T) and right ventricular myocardial performance index (RV-MPI) as predictors of RV infarction (RVI) and subsequently localizing the culprit lesion in the proximal right coronary (RCA) rather than other locations the distal RCA or dominant left circumflex (LCX) artery].Patients30 patients suffering from acute inferior infarction, were subjected to early conventional and pulsed wave tissue Doppler echocardiographic examinations, measuring (S_T) and calculating RV-MPI. Half of the patients had the culprit lesion proximal to the RV branch of the RCA and the other half had non-proximal RCA occlusion.ResultsS_T values were significantly reduced in patients with RVI. Cutoff value of S_T was found to be 11.9 cm/s with a sensitivity 80.0%, specificity 93.3%, positive predictive value 92.3% and negative predictive value 82.4% in the identification of proximal RCA lesion as the culprit lesion.The calculated RV-MPI was significantly different; its mean value was 0.666 ± 0.118 in the proximal RCA vs. 0.524 ± 0.133 in the non-proximal RCA patients. RV-MPI cutoff value proved to be 0.50 with sensitivity 80%, specificity 66.7%, negative predictive value 76.9% and positive predictive value 70.6%.ConclusionRVI caused by a proximal RCA lesion could be predicted using TDI to assess S_T and RV-MPI from the tricuspid annulus. Patients with S_T < 11.9 cm/s and RV-MPI ? 0.5 indicated most probably occlusion of the proximal RCA.