Doppler Tei Index for Assessment of Subclinical Right Ventricular Dysfunction Associated with Inferior Wall Acute Myocardial Infarction

ABSTRACT

BACKGROUND: Recognition of ischemic right ventricular (RV) dysfunction in the course of inferior wall left ventricular (LV) acute myocardial infarction is important in clinical practice. The Doppler Tei index is useful for estimating global cardiac function. However, the clinical usefulness of RV Tei index to diagnose subclinical RV dysfunction has not been investigated. The purpose of this study was to assess the clinical value of RV Tei index for diagnosis of subclinical RV dysfunction associated with inferior wall acute myocardial infarction who did not have definite ECG changes at right precordial leads. METHODS: The study population consisted of 22 consecutive patients (male 10, average age 57+/-12) with acute inferior myocardial infarction who did not have specific ST segment changes at right precordial leads. RV Tei index was measured by Doppler echocardiography and RV ejection fraction (EF) was measured by multigated blood pool (MUGA) SPECT. We defined subclinical RV dysfuntion as estimated RA pressure was > or =10 mmHg (group 1) by right heart catheterization. RESULTS: In patients with RV dysfunction, RV Tei index was significantly increased compared with those who did not have RV dysfunction (0.51+/-0.22 vs 0.35+/-0.18, p<0.05). RVEF by MUGA blood pool SPECT was significantly decreased in patients with RV dysfunction (35+/-11% vs 47+/-12, p<0.05). CONCLUSION: RV Tei index is simple and useful non-invasive method for diagnosis of subclinical RV dysfunction associated with inferior wall acute myocardial infarction who did not have typical ECG changes at right precordial leads.