Right ventricular function in patients with inferior myocardial infarction undergoing rescue percutanous coronary intervention: impact of right ventricular artery patency

Patients with inferior acute myocardial infarction [MI] and right ventricular [RV] MI represent a high-risk. Moreover, RV function is difficult to evaluate, given its geometry, inter relation with left ventricle, and sensitivity to load. Data concerning percutanous coronary intervention [PCI], RV dysfunction and prognosis are scared. To test the value of pulsed Doppler tissue imaging [DTI] to delineate RV dysfunction in acute inferior Ml and to determine the value of RV artery [RVA] patency following rescue PCI on RV functional recovery and short tern: clinical outcome. 40 patients with acute inferior MI who underwent rescue PCI to the right coronary artery. Tricuspid annulus [TA] and RV free wall DTI used to measure systolic [Sm] and diastolic [Em and Am] myocardial velocities plus myocardial power index [MPI=isovolu, nic relaxation+isovolumic contraction/ejection times]. According to RVA patency pts were divided into two groups [group I occluded RVA=21 pts, group 11 patent RVA=19 pts]. Data were compared to 12 control subjects. Electrocardiographic RV MI was confirmed in 14 pts [35%]. DTI revealed RV dysfunction in all pts vs. control [TA [9.31 +/- 0.36, 9.80 +/- 0.39, 12.1 +/- 0.05 cm/sec and 0.71+0.12 vs. 15.6 +/- 2.3 16.21 +/- 1.85 15.9 +/- 1.25 cm/sec and 0.55+0.14 for Sm, Em, Am, and MPI p<0.01] and RV free wall [10.9 +/- 3.1, 8.6 +/- 1.8, 13.8 +/- 3.1 cm/sec and 0.74 +/- 0.13 vs. 14.3 +/- 3.2, 10.1 +/- 3.4, 14.8 +/- 4.4 cm/sec and 0.54 +/- 0.15 for Sm, Em, Am, and MPI p<0.02]] Pts with RVMI had more severe RV dysfunction [TA [6.37 +/- 0.28, 6.11 +/- 0.48, 8.36 cm/sec and 0.86 +/- 0.23 for Sm, Em, Am, and MPI p<0.001] and RV free wall [6.81 +/- 4.21, 4.95 +/- 2.62, 10.64 +/- 2.93 un/sec and 0.91 +/- 0.21 for Sm, Em, Am, and MPI P<0.001]]. Similarly pts with occluded RVA had significantly lower RV free wall and TA velocities and higher MPI I [10.9 +/- 1.3, 8.9 +/- 0.39, 9.6 +/- 0.83 cm/sec and 0.83 +/- 0.llfor RVfree wall Sm, Em, An, and MPI p<0.05] and [8.20 +/- 0.47, 8.90 +/- 0.28, 11.2 +/- 0.09 cm/sec and 0.78+0.22 for TA Sm, Em, Am, and MPI p<0.0l]]. After PCI, pts with patent RVA showed significant improved RV function [high RV and TA velocities with low [MPI] with less in hospital [9/21 vs. 2/19 p=0.034], and 3 months events [7/21 vs. 1/19 p=0.046]. Doppler tissue imaging is highly sensitive to detect subclinical R V dysfunction in patients with acute inferior myocardial infarction. Successful reperfusion of R V artery was associated with better recovery of RV function and less short term clinical adverse cardiac events

Trichomonas vaginalis is not a rare sexually-transmitted disease among Egyptian men

The objective of this work was to determine the etiological role of Trichomonas vaginalis in urethritis among Egyptian men. Urethral swabs were obtained from 90 male patients presenting with urethritis and from 60 patients presenting with sexual dysfunction or infertility as controls. The swabs were examined by wet mount examination, culture on CPLM medium and polymerase chain reaction [PCR] to detect the presence of Trichomonas vaginalis. The results revealed that Trichomonas vaginalis was found in 16.7% of patients with urethritis and in 8.3% among the controls. In conclusion, Trichomonas vaginalis is an important consideration in urethritis among Egyptian men