Echocardiographic Assessment of Right Atrial Volume Index in Acute Inferior Myocardial Infarction Patients

Acute myocardial infarction can cause the right ventricle (RV) dysfunction. The echocardiography (ECHO) can provide the first clue to RV involvement in patients with inferior MI. In addition, the echocardiographic assessment of RV function can help in the early diagnosis and management of these patients in whom ECG cannot be diagnosed for RV involvement. Consequently, the current study measured the right atrium (RA) volume index instead of conventional RV echocardiographic parameters in order to evaluate the RV function in patients with poor RV echo windows.

To this end, 116 patients with inferior myocardial infarction (MI) (66 with isolated inferior and 50 with inferoRV MI) were included after 24-72 hours after MI. Furthermore, RV systolic function parameters were measured, including tricuspid annular plane systolic excursion (TAPSE), fractional area change, and peak systolic velocity of the tricuspid annulus at tissue Doppler imaging (TDI) mode (RVSm). Finally, monoplane Simpson’s and biplane area length methods were used to measure RA volume index in these patients.

Based on the results, the RA volume index was high in both inferior and inferoRV MI patients but was significantly higher in inferoRV MI. Patients with inferoRV MI more likely had RAEF≤35%, high E/E’, and high right ventricular enddiastolic diameter (RVEDD) compared to isolated inferior MI. The correlation between RAVI in both groups was very significant with E/E’ and RVEDD.

RA volume index is a good parameter for demonstrating RV dysfunction in patients with inferior and inferoRV MI.