"Simpson's right ventricle ejection fraction versus tricuspid annular plane systolic excursion in patients with isolated left ventricle anterior myocardial infarction".

Background: Unlike left ventricular, right ventricular (RV) function has not been widely studied after anterior myocardial infarction. This is because standard 2 dimensional echocardiographic evaluation of RV volumes and ejection fraction is cumbersome due to difficulty in exact delineation of RV endocardial borders because of prominent trabeculations and crescentric shape of the chamber.

Methods And Results: 50 patients of isolated LV anterior myocardial infarction subdivided into two subgroups--Group-1 with stenosis of Left anterior descending artery (LAD) and Group-2 with stenosis of both LAD and left circumflex artery were studied. Any associated RV infarction was excluded in all patients by ECG, Echocardiography and Right Coronary Angiography .From apical four chamber view of echocardiography, right ventricular ejection fraction (RVEF) was measured by Simpson's method and the systolic motion of the tricuspid annulus (TAPSEx) was recorded with the use of 2 dimensional guided M-Mode tracings both at lateral and the septal side of annulus. There was no significant difference in RVEF between study patients and control subjects. (p > 0.05). However septal TAPSEx was significantly reduced in patients of anterior myocardial infarction as compared to healthy subjects. Reduction was more marked in subgroup-2 patients having stenosis of both LAD and LCx arteries.(p < 0.005).

Conclusion: Our study results suggests that TAPSEx is simple, quick and better non geometric echocardiographic parameter than RVEF to assess RV functions in patients of anterior infarction.