Evaluation of right atrial volumes and functions by real‐time three‐dimensional echocardiography in patients after acute inferior myocardial infarction

Background Right ventricle ( RV ) involvement causes acute systolic and diastolic functional alterations in the RV in patients after inferior myocardial infarction ( IMI ), which may result in an increase in left ventricle ( LV ) end‐diastolic and right atrial ( RA ) pressure. In our study, we sought to evaluate RA volumes and mechanical functions using real‐time three‐dimensional echocardiography ( RT 3 DE ) in IMI patients with or without RV involvement. Methods Ninety‐six consecutive patients with IMI (mean age: 59.7 ± 10.2 years, 60 female) were included. RV myocardial involvement ( RVMI ) was defined as the presence of a culprit lesion at the proximal portion of the first RV marginal branch in coronary angiography. The study population was divided into two groups: IMI (58.3%) and IMI  +  RVMI (41.7%). Patients were evaluated using conventional two‐dimensional echocardiography (2 DE ) and RT 3 DE . Results In RT 3 DE measurements, IMI  +  RVMI patients had significantly higher RA phasic volumes and worse conduit mechanical function. A receiver operating characteristic ( ROC ) curve analysis revealed that an RT 3 DE RA maximum volume (Vmax) index > 27.9 mL/m 2 was an independent predictor of RV involvement in patients after acute IMI , with a sensitivity of 80.0% and a specificity of 89.3%. Conclusions Right ventricle involvement may cause an increase in RA phasic volumes and deterioration of conduit function in patients with acute IMI .