Assessing Right Atrial Function With 2D Speckle Tracking Echocardiography in Inferior ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Karem, Khalid; Zareef, Mikhail M; El Missiri, Ahmed; Onsy, Ahmed

doi:10.21608/asmj.2025.370459.1420

Assessing Right Atrial Function With 2D Speckle Tracking Echocardiography in Inferior ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Document Type : Original Article

Authors

Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

10.21608/asmj.2025.370459.1420

Abstract

Background: Right atrium (RA) plays a crucial role in cardiac function, yet evaluation of RA function in myocardial infarction (MI) has been underexplored. Inferior ST segment myocardial infarction (STEMI) may affect RA function. Two-dimensional speckle tracking echocardiography (2D-STE) provides a novel, non-invasive means of assessing RA mechanics.
Aim: To evaluate and compare RA function in patients with inferior STEMI, with and without RV infarction, against healthy controls using 2D-STE.
Patients and Methods: This prospective, observational, case-control study included 150 participants: 100 patients with inferior STEMI undergoing primary percutaneous coronary intervention (PCI) and 50 age-matched healthy controls. STEMI group was further divided into those with RV infarction (n = 26) and those without (n = 74). RA function was assessed using 2D-STE, with RA strain parameters measured in reservoir (RASr), conduit (RAScd), and contraction (RASct) phases.
Results: Compared to controls, patients with inferior STEMI exhibited significantly reduced RASr (33.54 ± 5.98% vs. 42.42 ± 5.85%, p < 0.001) and RAScd (22.48 ± 5.16% vs. 25.92 ± 4.21%, p < 0.001), while RASct remained comparable (p = 0.062). Within the STEMI group, RA strain parameters did not significantly differ between those with and without RV infarction (p > 0.05). However, RA emptying fraction (RAEF) was significantly lower in RV infarction patients (56.12 ± 10.58% vs. 60.26 ± 7.18%, p = 0.029).
Conclusion: RA reservoir and conduit functions are significantly impaired in inferior STEMI patients, irrespective of RV infarction. However, RAEF is reduced in patients with RV infarction, correlating with impaired RV function.

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