Differentiation of the left- from right-side ventricular septum in acute anterior myocardial infarction by tissue doppler imaging

Objectives: This study was to evaluate the longitudinal and radial function of the left- and right-side ventricular septum (Ls and Rs) in patients with acute anterior myocardial infarction (AMI) by tissue Doppler imaging. Methods: Thirty patients with anterior ST-elevation AMI and revascularization and 20 age-matched normal subjects were enrolled as controls. The longitudinal and radial systolic tissue velocity (TV), strain rate (SR) and strain (É) of both Ls and Rs were assessed. Results: In normal, there were no significant differences of longitudinal TV, SR and É between the Ls and Rs. The radial TV was same directed, but larger in Ls than Rs (P < 0.001). The radial SR and É were positive values of Ls and negative values of Rs, but the degrees were similar in both sides. In AMI, longitudinal and radial TV were significantly decreased in both sides. However, longitudinal and radial SR and É were significantly decreased in Ls only (P < 0.001 in all). Fourteen patients with AMI who showed no functional recovery had more reduced radial É of Ls (3.9 A ± 1.5% vs. 5.5 A ± 2.1%, P = 0.02), but not longitudinal É of Ls than the other 16 patients with recovery. Conclusion: This study showed the ventricular septum can be functionally differentiated the Ls from the Rs, which can be well demonstrated by SR imaging. The impairment of radial rather than longitudinal function of the Ls was related to no functional recovery. (Echocardiography 2011;28:38-43)