Sevimli Serdar, Gundogdu Fuat, Aksakal Enbiya, Arslan Sakir, Tas Hakan, Islamoglu Yahya, Buyukkaya Eyup, Gurlertop Hanefi Yekta, Senocak Huseyin
Department of Cardiology, Medical School Hospital, Ataturk University, Erzurum, Turkey.
Echocardiography. 2007 Aug;24(7):732-8. doi: 10.1111/j.1540-8175.2007.00470.x.
This study was planned to assess strain and strain rate properties of right ventricle in patients with RV myocardial infarction.
Thirty patients with acute inferior myocardial infarction were included in this study. The presence of right ventricular infarction in association with an inferior myocardial infarction was defined by an ST-segment elevation 0.1 mV in lead V4 R. According to this definition, 15 patients had electrocardiographic signs of inferior myocardial infarction without right ventricular infarction (group I), and 15 patients had electrocardiographic signs of inferior myocardial infarction with right ventricular infarction (group II). Echocardiography was performed using a Vivid 5 System (GE Ultrasound; Horten, Norway) and a 2.5-MHz transducer. 2-dimensional color doppler myocardial imaging (CDMI) data for longitudinal function were recorded from the RV free wall using standard apical view. Offline analysis of the myocardial color Doppler data for regional velocity (V), strain rate (Sr), and strain (S) curves was performed using a special software program (EchoPac 6.4 Vingmed, Horten, Norway). They were assessed in basal, middle and apical segments of the RV. The differences between different groups were assessed with the Mann-Whitney U-test. A value of P < 0.05 was considered statistically significant.
Systolic tissue velocity, strain, strain rate of basal (4.8 +/- 0.8 cm/s vs 6.5 +/- 1.2 cm/s, -12 +/- 3% vs -24 +/- 5%, 1.28 +/- 0.3/s vs -1.9 +/- 0.4/s; P < 0.001, <0.001, <0.001, respectively) and mid (4.2 +/- 0.5 cm/s vs 5.4 +/- 0.5 cm/s, -16 +/-3% vs -26 +/- 4%, -1.2 +/- 0.3/s vs -2.1 +/- 0.3/s; P < 0.001, <0.001, <0.001, respectively) segments of right ventricle were significantly lower in patients with RV infarction than in patients without RV infarction. There were no differences between groups for apical strain, strain rate, and systolic tissue velocity.
This study demonstrates that right ventricular strain and strain rate were lower in patients with left ventricular inferior wall myocardial infarction with, compared to without, right ventricular infarction.
本研究旨在评估右室心肌梗死患者右心室的应变及应变率特性。
本研究纳入30例急性下壁心肌梗死患者。下壁心肌梗死合并右心室梗死的诊断标准为V4R导联ST段抬高0.1mV。根据此标准，15例患者有下壁心肌梗死心电图表现但无右心室梗死（I组），15例患者有下壁心肌梗死心电图表现且合并右心室梗死（II组）。使用Vivid 5系统（GE超声；挪威霍滕）及2.5MHz探头进行超声心动图检查。采用标准心尖视图，从右室游离壁记录二维彩色多普勒心肌成像（CDMI）纵向功能数据。使用特殊软件程序（EchoPac 6.4，挪威霍滕Vingmed公司）对心肌彩色多普勒数据进行离线分析，获取局部速度（V）、应变率（Sr）及应变（S）曲线。在右室的基底段、中间段及心尖段进行评估。采用Mann-Whitney U检验评估不同组间差异。P<0.05为差异有统计学意义。
右室梗死患者右室基底段（4.8±0.8cm/s对6.5±1.2cm/s，-12±3%对-24±5%，1.28±0.3/s对-1.9±0.4/s；P分别<0.001、<0.001、<0.001）及中间段（4.2±0.5cm/s对5.4±0.5cm/s，-16±3%对-26±4%，-1.2±0.3/s对-2.
