Phenotype of reduced right ventricular strain in patients presenting with inferior ST segment elevation myocardial infarction.

Background
Right ventricular global longitudinal strain (RVGLS) is a measure of right ventricular systolic function that has prognostic implications. We seek to examine the relationship between RVGLS and clinical indices in patients with inferior ST elevation myocardial infarction (ISTEMI).

Methods
Patients with ISTEMI presenting to an academic medical center over a nine month period were retrospectively examined. Clinical indices at presentation were abstracted from the medical records. RVGLS analyses were obtained using the TomTec Software ( Image Arena 4.6; Munich, Germany). Patients with sub-optimal images were excluded. Continuous and categorical variables were analyzed using pearson correlation coefficients (cc) and ANOVA respectively using SAS 9.4.

Results
A total of 30 patient were included in the present analysis. Mean age was 62 years and 61% were female. Average RVGLS was -13.0. There was no correlation between RVGLS and age ( cc 0.15), body mass index ( cc 0.12), hypotension (0.25) or repeat hospitalization ( cc 0.31 ). Patients with prior coronary intervention (CI) have lower RVGLS compared to patients without prior CI ( figure)

Conclusions
In this preliminary analysis, there was no relationship between age, adiposity as measured by BMI, or hypotension in patients presenting to the hospital with ISTEMI. Patients with prior CI have lower right ventricular function as measured by RVGLS compared to patients without any history of prior CI.