| Acute coronary syndrome (ACS) includes unstable angina (UA), non-ST segment elevated myocardial infarction (NSTEMI) and ST segment elevated myocardial infarction (STEMI). In this study, we evaluated the systolic and diastolic function of left and right ventricle(RV), especially the RV function and interaction of the two ventricles of the cases with ACS by using two-dimensional echocardiography(2-DE), Doppler flow echocardiography and pulsed-wave Doppler tissue imaging(DTI). Main results:60 normal subjects, 52 patients with UA and NSTEMI (UA group) and 76 patients with STEMI (AMI group) were selected. AMI was divided into three subgroups, including 34 cases with anterior myocardial infarction (including high lateral wall infarction), 29 cases with inferior myocardial infarction and without right ventricular infarction (including true posterior wall infarction) and 13 cases with inferior myocardial infarction and right ventricular infarction.1. Comparison of left and right ventricular function among normal subjects, UA and AMI(1) The results of ventricular function by 2-DE and colored Doppler flow echocardiography: Compared with control group, the parameters about pulmonary artery and aortic artery flow had no change among all groups. Pulmonary artery systolic pressure in AMI was decreased compared with that in healthy individuals. The left ventricular ejection fraction (LVEF) in AMI was decreased compared with that in both healthy individuals and patients with UA. LVEF in UA was similar to that of the healthy individuals. In the parameters of tricuspid blood flow, the peak velocity of early filling (E) in UA was similar to that of in healthy individuals while in AMI was decreased. The peak velocity of late filling (A) hasno change. The ratio of early/late filling (E/A) was lower in patients with UA and AMI compared with that in healthy individuals. In the parameters of mitral blood flow, E in UA and AMI had no change. A value in UA was increased and E/A ratio was decreased compared with that in healthy individuals. E/A ratio had no difference between AMI and healthy individuals.(2) The results of ventricular function by DTI: In the parameters of tricuspid annular and mid-segment of right ventricular free wall (RVFW) motion, peak systolic velocity (Vs) in all patients had no change. The ratio of peak early diastolic velocity (Ve) and peak late diastolic velocity (Va), that is Ve/Va (e/a) of tricuspid annulus in UA and AMI were decreased compared with that in healthy individuals. The e/a ratio of RVFW had no change. In the parameters of mitral inner annular and mitral outer annular motion, peak systolic velocity (Vs) in UA was similar to that of healthy individuals, but in AMI, was decreased compared with both healthy individuals and patients with UA. Mitral inner and outer annular e/a ratio in patients with UA and MI decreased compared with healthy individuals.2. Comparison of left and right ventricular function among three subgroups of AMIThe main parameters (E/A ratio of tricuspid flow and mitral flow; Vs, Ve, Va, e/a ratio of mitral inner and outer annulus, tricuspid annulus and mid-segment of RVFW motion) of systolic and diastolic function had no difference among the patients with anterior myocardial infarction, inferior myocardial infarction without right ventricular infarction and inferior myocardial infarction with right ventricular infarction.3. The results about interaction between left and right ventricular function Mitral inner annular Vs had correlated to tricuspid annular Vs and to Vs ofRVFW in healthy individuals and UA. There was no correlation between mitral outer annular Vs and tricuspid annular Vs, as well as between mitral outer annular Vs and Vs of RVFW. Mitral inner annular e/a ratio and mitral outer annular e/aratio had correlated to tricuspid lateral annular e/a ratio in healthy individuals, UA and AMI. There was no correlation between mitral annular e/a ratio and e/a ratio of RVFW.4. The influence of other factors on ventricular function in AMI(1)The c...
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