Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography.
Fiche publication
Date publication
mars 2015
Journal
The international journal of cardiovascular imaging
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MARIE Pierre-Yves, Pr FELBLINGER Jacques
Tous les auteurs :
Huttin O, Lemarié J, Di Meglio M, Girerd N, Mandry D, Moulin F, Lemoine S, Juillière Y, Felblinger J, Marie PY, Selton-Suty C
Lien Pubmed
Résumé
To assess the pattern of right ventricular (RV) functional recovery in a cohort of patients with successful reperfusion of a first episode of acute myocardial infarction (AMI) with 2D speckle-tracking echocardiography and cardiac magnetic resonance imaging (CMR). Ninety-five revascularized AMI patients were prospectively included (56.8 ± 11.1 years, 48 inferior, 47 anterior). RV function was assessed by echocardiography and CMR within the initial 72 h and 6 months later. A RV global strain was calculated while averaging strain values from septal, lateral and inferior walls. At the acute phase, RVEFCMR was lower in inferior than in anterior AMI patients (52.5 ± 6.8 vs. 56.0 ± 4.8, p = 0.006). Similarly, RV global, inferior and lateral strains were lower in inferior MI patients (p < 0.001 for all) whereas septal strain was not significantly different across groups. At 6 months, RVEFCMR and all strain parameters improved compared to baseline. Improvements were more substantial for patients with inferior than with anterior MI. RV parameters ultimately reached similar levels in the two groups at 6 months except for inferior strain which remained lower in patients with inferior MI (-24.5 ± 6.5 vs. -27.5 ± 5.4, p = 0.03). In low risk patients after AMI, RV function ultimately recovered over the 6 months of follow up. Higher levels of both initial impairment and subsequent recovery were observed for inferior MI. Although RV function was relatively preserved in these patients, RV strain analysis revealed a persistent impairment of RV inferior strain in patients with inferior MI, which may not be identified by RVEFCMR or conventional echocardiographic parameters.
Mots clés
Aged, Anterior Wall Myocardial Infarction, complications, Female, Humans, Inferior Wall Myocardial Infarction, complications, Magnetic Resonance Imaging, Male, Middle Aged, Myocardial Contraction, Myocardial Revascularization, Predictive Value of Tests, Prospective Studies, Recovery of Function, Stroke Volume, Time Factors, Treatment Outcome, Ultrasonography, Ventricular Dysfunction, Right, diagnostic imaging, Ventricular Function, Right
Référence
Int J Cardiovasc Imaging. 2015 Mar;31(3):537-45