Relationship between mean right atrial pressure and Doppler parameters in patients with right ventricular infarction

Background: The incidence of an inferior left ventricular infarction involv ing the right ventricle is very high, ranging from 14 to 84%. Isolated righ t ventricular infarction accounts for < 3% of all cases of infarction. Hypothesis: The aim of the present study was to assess the relationship bet ween Doppler parameters of hepatic vein and tricuspid inflow as well as mea n right atrial (RA) pressure in patients with right ventricular infarction. Methods: In all, 59 consecutive patients with inferior left ventricular inf arction involving the right ventricle were selected for the study. All pati ents underwent Doppler echocardiographic evaluation of tricuspid and hepati c vein parameters and catheterization of the right side of the heart. Patie nts were divided into two groups according to the presence or absence of se vere tricuspid regurgitation. Results: In patients with severe tricuspid regurgitation, a significant cor relation (r = 0.64; p < 0.001) between RA maximal volume and mean right atr ial pressure (RAP) was found, and the sensitivity of RA maximal volume in i dentifying mean RAP > 7 mmHg was 64% with a specificity of 78%. In patients without seven tricuspid regurgitation, the most significant relationship w as observed between mean RAP and inferior vena cava collapse index. Signifi cant correlations between maximal and minimal diameters of the inferior ven a cava were also observed. Conclusions: Echocardiographic and Doppler parameters may be useful for eva luating mean RAP in patients with right ventricular infarction. In patients with severe tricuspid regurgitation, the more important parameters are max imal and minimal RA volumes. In patients without seven tricuspid regurgitat ion together with right atrial volume, the important parameters are acceler ation and deceleration time of the tricuspid inflow peak E velocity and hep atic systolic and diastolic venous flow.