Open Access
Subscription Access
Open Access
Subscription Access
Echocardiographic Evaluation of Hepatic Venous Doppler flow in Patients with Isolated Left Ventricle Anterior Myocardial Infarction
Subscribe/Renew Journal
Introduction: The importance of RV functions as a predictor of outcome among patients with heart failure, myocardial infarction and pulmonary embolism has been established. Hepatic venous (HV) doppler flow predicts right atrial pressure and right ventricular (RV) dysfunction. Doppler technique offers unique advantage for evaluation of RV functions in that they are independent of complex geometry and shape of RV.
Aims And Objectives: To evaluate non-invasively right atrial pressure and predict right ventricular functions in patients with isolated left ventricle anterior myocardial infarction (LV-AMI) by analyzing hepatic venous doppler flow and to correlate it with left ventricle ejection fraction (LVEF)
Material And Methods: The study group comprised of 50 patients with isolated LV-AMI with normal right coronary angiogram, further subdivided into 2 subgroups:
Sub-group-1 consisted of 25 patients with stenosis of proximal left anterior descending artery (LAD)
and Sub-group-2 composed of 25 patients with stenosis of both LAD and left circumflex artery (LCx.). The control group comprised of twenty five age, sex, BMI, pulse and blood pressure matched healthy subjects.
Observations: A wave peak velocity and VTI were increased in both subgroups of AMI, X wave peak velocity and VTI was reduced in both subgroups of AMI, Y wave peak velocity and VTI was reduced in both sub-groups of AMI. VI ratio remained unchanged. On multivariate analysis LVEF and LVFS were independent negative predictors of X wave VTI.
Conclusion: This study demonstrates that even in patients with isolated LV AMI there is RV dysfunction due to 'ventricular interdependence' and hepatic venous doppler is non - geometric sensitive echocardiographic parameter, to detect RV dysfunction non-invasively.
- (1) Ommen SR, Nishimura RA, Hurrel DG, Klarich KW. Assessment of right atrial pressure with 2-dimensional and Doppler echocardiography: a simultaneous catheterization and echocardiographic study. Mayo Clin Proc 2000;75:24-9
- (2) Korytnikov KL. Possibility of the evaluation of right ventricular failure in ischaemic heart disease based on pulse Doppler ultrasonography of large hepatic veins.Klin Med 1992;70:34-7
- (3) Zehender M, Kasper W, Kauder E, Schonthaler M, Olschewski M, Just H. Right Ventricular Infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl. J Med. 1993;328:981-88.
- (4) Miller D, Farah MG, Liner A,fox Keith, Schluchter M, Hoit BD. The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance index. J.Am.Soc. Echocardiogr 2004;17:4437.
- (5) Mehrotra R, Bansal M, Kasliwal R, Chopra HK,Sambi RS, CK Krishna chocardiographicassessment of right heart hemodynamics. Indian Heart Journal 2009;61:397-402.
- (6) Isobe M Yazaki Y, Takaku F, Harak Kashda M, Yamaguchi T etal Right ventricular filling detected by pulsed Doppler echocardiography during the convalescent stage of inferior wall acute myocardial infarction.Am J Cardiol 1987;59:124550
- (7) Startt R H, Wagner G S, Idekar R E. Myocardial infarction. In Comprehensive Electrocardiography. Theory and Practice in Health & Disease eds Peter W Mac farlane, T D Veitch Lawrie Newyork Vol 1:1989;565-629
- (8) Nagueh SF, Kopelen HA, Zoghbi WA. Relation of mean right atrial pressure to echocardiographic and Doppler parameters of right atrial and right ventricular function.Circulation 1996;93:1160-69
- (9) Himura Y, Kannagi T, Tamo H,Nakamura Y, Kumada Ta, Kawai C.Venous flow velocity patterns and cardiac functions studied by Doppler echocardiography.J Cardiol 1988;18:775-86.
Abstract Views: 260
PDF Views: 0