Search

Background: When compared to cases who had isolated inferior infarctions, those with right ventricular infarctions that occur alongside inferior infarctions had greater odds of bradycardia or severe hypotension, needing pacing support, with higher in-hospital rate of death. Objective: The aim of the current study to evaluate pulsed wave TDI role together with other Conventional Echo-Doppler modalities in the right ventricular (RV) function assesement among acute inferior ST elevation myocardial infarction (STEMI) associated with RV infarction. Patients and methods: A two arm, single blinded randomized controlled clinical trial was performed on 100 cases, presenting with acute inferior myocardial infarction (MI) associated with RV infarction, during the period from January 2020 to July 2022. Patients were divided into two groups; Group A involved 50 cases who underwent coronary angiography and primary percutaneous coronary intervention (PCI), while Group B involved 50 cases who received thrombolytic therapy. Results: Patients who had undergone primary PCI showed highly significant improvement of RV systolic function, in comparison with patients who received thrombolytic therapy. In comparison to Group B (TT), Group A (PPCI) showed a significant higher S' (14.19±1.77cm/s vs. 10.01±2.66cm/s, P<0.001) and longer ET (285.41±38.83ms vs. 233.82±51.47ms, P<0.001), while isovolumetric times (IVCT and IVRT) were significant lower in Group A versus Group B (62.80±13.68ms vs. 79.53±16.26ms, P<0.001; 64.43±19.07ms vs. 80.73±19.20ms, P<0.001, respectively). Conclusions: Primary PCI is superior to thrombolytic therapy in terms of improvement of RV function where pulsed wave TDI is a more sensitive diagnostic tool of RV infarction. [ABSTRACT FROM AUTHOR]

Background: The primary reference criterion for evaluating coronary artery stenosis functional significance is fractional flow reserve (FFR). It helps the interventionist to define appropriate angiographic borderline coronary lesions that should or should not be treated with a stent. Objective: To evaluate the experience of the cardiology department, MUST University, on the use of FFR and its impact on patients with a borderline coronary lesion as regard revascularization decision-making. Patients and methods: A retrospective study were done on 86 patients with borderline lesions undergoing coronary angiograms for whom FFR was performed. Three experienced cardiac interventionists re-analyzed their coronary angiography and whether to delay or conduct revascularization with borderline stenotic lesions (40-70 %). A distinction was made between the findings of quantitative coronary angiography (QCA), visual and functional assessment of coronary stenosis severity. Result: Eighty-six patients (51 males and 35 females) with a mean age of 58.60 ± 9.20 were enrolled in the current study. FFR was < 0.80 in 26.74% (23/86) of the patients, and they had coronary angioplasty. Between quantitative evaluation of lesion diameter by FFR and visual measurement, the correlation was -0.645 (P < 0.001). Seven patients (8.139%) had FFR > 0.8 left main (LM) lesion and for the other vessels with severe coronary lesions, stenting was performed. Conclusion: In patients having borderline coronary artery stenosis, FFR is an important tool for clinical decisions making about procedures of revascularization. FFR results in alteration in the coronary intervention judgment. [ABSTRACT FROM AUTHOR]