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Evaluation of Right Ventricular Dyssynchrony in Patients with Acute Inferior Myocardial Infarction and Its Relation with Mortality
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  • batur gonenc kanar,
  • Kursat Tigen,
  • Murat Sunbul,
  • Altug Cincin,
  • Emre Gurel,
  • Nurten Sayar,
  • Alper Kepez,
  • Beste Ozben
batur gonenc kanar
Marmara Universitesi Tip Fakultesi
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Kursat Tigen
Marmara University School of Medicine
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Murat Sunbul
Marmara University School of Medicine
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Altug Cincin
Marmara University Faculty of Medicine
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Emre Gurel
Marmara University School of Medicine
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Nurten Sayar
Marmara University
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Alper Kepez
Marmara University School of Medicine
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Beste Ozben
Marmara University Faculty of Medicine
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Peer review status:IN REVISION

25 Jun 2020Submitted to Echocardiography
26 Jun 2020Submission Checks Completed
26 Jun 2020Assigned to Editor
28 Jun 2020Reviewer(s) Assigned
15 Jul 2020Review(s) Completed, Editorial Evaluation Pending
16 Jul 2020Editorial Decision: Revise Major
20 Jul 20201st Revision Received
20 Jul 2020Submission Checks Completed
20 Jul 2020Assigned to Editor
20 Jul 2020Reviewer(s) Assigned
01 Aug 2020Review(s) Completed, Editorial Evaluation Pending
03 Aug 2020Editorial Decision: Revise Major

Abstract

Purpose: The aim of this study was to evaluate right ventricle (RV) dyssynchrony and its relation with mortality using speckle tracking echocardiography (STE) in patients with acute inferior myocardial infarction (IMI). Methods: One hundred and fifty-eight consecutive patients with acute IMI treated with primary percutaneous coronary intervention and 44 healthy subjects were included. RV myocardial involvement (RVMI) was defined as an elevation greater than 1 mm in V1 or V4R and/or the presence of a culprit lesion at the proximal portion of the first RV marginal branch after reviewing coronary angiography. Patients were followed for three years to determine the cardiovascular mortality. Results: Overall, 70 patients with IMI had RVMI. IMI patients had significantly higher RV peak systolic longitudinal strain dyssynchrony (PLSSD) index, lower peak longitudinal systolic strain (PLSS), longer time to PLSS and time to PLSS differences compared to healthy controls while the patients with RVMI had significantly worse values compared to patients without RVMI and healthy controls. Twenty-seven patients (17.1%) died within two years. RVMI was more prevalent in mortality group and they had significantly higher RV PSSD index, whereas they had lower RV free wall PLSS and longer time to PLSS differences. ROC analysis revealed that a RV PLSSD index > 65 ms predicted mortality with a sensitivity of 88.9% and specificity of 71.8,% in IMI patients. Conclusions:Intra- and interventricular dyssynhcrony may develop in patients with acute IMI, especially in those with RV involvement, which might have a negative effect on the prognosis of these patients.