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Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but RA affection is not fully elucidated in patients with myocardial infarction (MI) Objective: To assess RA function by 2-Dimensional speckle tracking echocardiography (2D-STE) imaging in patients with acute first left ventricular (LV) inferior wall MI with and without RV involvement. Patients & methods:-Sixty patients with acute first inferior MI were included in this study; 30 patients had ECG signs of inferior MI without RV infarction (group II) and 30 patients had ECG signs of inferior MI with RV involvement (group III). Twenty five age and sex -matched healthy volunteers were included as a control group (group I). Assessment of RA function was done in all subjects using (2D-STE) for measurements of RA septal and free walls longitudinal strain and strain rate (SR). Results:-RA septal wall & global systolic strain were significantly reduced in group III (22.5±14.8% and 40.4±24.5%) compared to group I (37.5±16.3% and 60.4±22.4%) and group II (35.7±17.4% and 54.9±25.73%), (P<0.001), (P=0.008) respectively. RA septal wall and global early diastolic strain rate were also significantly reduced in group III (- 0.77±0.46 s-1 and – 3.61±0.55 s-1) compared to group I (-1.38±0.74 s-1 and – 4.41±0.67 s-1) and group II (-1.07±0.76 s-1 and -3.73±0.76 s-1), (P=0.005), (P<0.001) respectively. Conclusion:-In patients with first LV inferior wall MI with RV involvement, RA functional parameters (RA septal and global strain and SR) were significantly impaired in comparison to healthy controls and patients with first LV inferior wall MI without RV affection. This result may illustrate the significant relation between RV & RA which is still under research.

cardiology and cardiovascular research

Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography