Doppler echocardiographic evaluation of right ventricular function in patients with right ventricular infarction

The aim of the present study was to assess the utility of the myocardial pe rformance index in patients with right ventricular infarction. During the s tudy period, 120 patients were evaluated: 50 patients had a right ventricul ar infarction and 70 patients had an inferior left ventricular infarction w ithout right ventricular involvement. On admission, an echocardiogram was o btained from all patients prior to the initiation of thrombolytic therapy. The right ventricular myocardial performance index was calculated, as were the Doppler-derived parameters of the right side of the heart. All patients with right ventricular infarction had undergone a right ventricular dilati on, compared with 70 patients with left ventricular infarction (right ventr icular end diastolic diameter 32 +/- 13 versus 26 +/- 24 mm; P < 0.01) and increased areas (diastolic area 24.8 <plus/minus> 9.9 versus 15.1 +/- 6.8 c m(2); P < 0.01). Tricuspid regurgitation was detected in 26 patients. The m ean peak velocity of tricuspid regurgitation was 3.8 +/- 0.8 m/s. The Doppl er intervals, isovolumetric contraction times (136 +/- 30 versus 49 +/- 11 ms; P +/- 0.01), and relaxation times (71 +/- 28 versus 37 +/- 9 ms; P < 0. 01) were prolonged in patients with right ventricular infarction, whereas t he ejection time was significantly reduced (250 +/- 31 versus 330 +/- 26 ms ; P < 0.001). The myocardial performance index was significantly increased in patients with right ventricular infarction (0.85 +/- 0.2 versus 0.26 +/- 0.1; P < 0.01). The inferior vena cava collapse was reduced in all patient s with right ventricular infarction (35 +/- 20%). The right ventricular myo cardial performance index was a useful indicator of right ventricular perfo rmance in patients with right ventricular infarction. The use of echocardio graphic parameters of the right side of the heart and Doppler echocardiogra phic parameters of right ventricular function provides a reliable diagnosis of right ventricular infarction.