Assessment of Right Ventricular Functions in Patients with Ischemic Heart Disease before and after Percutaneous Coronary Intervention using Colored Tissue Doppler Imaging

Abstract

Background: Right Ventricular (RV) dysfunction considered as a predictor of mortality in patients with ischemic heart disease (IHD). Aim: This study was aimed to evaluate the impact of elective coronary artery revascularization on RV myocardial function in Egyptian patients with IHD using Colour Tissue Doppler Imaging (CTDI). Methods: The present study is prospective observational self-control study. Fifty consecutive patients with IHD were included in this study. All participants were subjected to physical examination, Electrocardiograph (ECG), Laboratory test, Transthoracic Echocardiography and color tissue Doppler Imaging. The RV myocardial performance index (MPI) and S’/RMPI index were calculated in TDI modalities parameters. Results: No significant differences were detected between the demographic characteristics of the investigated patients. Tricuspid annular plane systolic excursion (TAPSE) by echocardiographic RV function parameters was improved significantly after PCI (P=0.001). Most of RV myocardial function showed significant improvement after PCI by using PW-DTI: Early and late diastolic function: The E` and A` diastolic wave velocities were improved significantly after PCI (P= 0.003, P= 0.008 respectively), RMPI (P= 0.008) Sˋ/RIMP ratio (P=0.04). The myocardial functions showed significant improvement after PCI by using color-coded tissue Doppler; E` wave (P= 0.02), RMPI was improved significantly after PCI (P= 0.01). Conclusion: The TAPSE and Doppler tissue indices added important information to the RV functions after successful percutaneous revisualization of coronary arteries. The measurements performed by color-coded TDI derived myocardial velocities at basal, mid and apical might have added additional data describing RV function and its recovery after RV ischemia