Diagnostic value of a combined model based on real-time three-dimensional echocardiography for acute inferior ST-segment elevation myocardial infarction complicated with right ventricular myocardial infarction
HAN Yue
RUAN Shengfei
WANG Junling
ZHAI Feifei
Abstract：Objective To investigate the diagnostic value of a combined model based on real-time three-dimensional echocar-diography(RT-3DE)for acute inferior ST-segment elevation myocardial infarction(STEMI)complicated with right ventricular myocardial infarction(RVMI).Methods Sixty-three patients with acute inferior STEMI were divided into RVMI group(n=33)and non-RVMI group(n=30)based on ST-segment elevation≥1 mm in lead V4R.Within 24 hours of admission,two-dimensional echocardiography was employed to measure right ventricular basal diameter(RVBD),mid-cavity diameter(RVMD),longitudinal diameter(RVLD),tricuspid annular plane systolic excursion(TAPSE),and systolic velocity(S').Real-time three-dimensional echocardiography(RT-3DE)was used to assess right ventricular end-diastolic volume(RVEDV),end-systolic volume(RVESV),stroke volume(RVSV),RVEF,and RVSI was calculated.Independent predictors of RVMI in acute inferior STEMI were identified through binary logistic regression analysis,and then,a combined predictive model.The di-agnostic performance was evaluated by receiver operating characteristic(ROC)curve model was constructed.Results Com-pared with the non-RVMI group,the RVMI group showed increased RVBD,RVLD,RVEDV,RVESV,and RVSI,along with decreased S',TAPSE,and RVEF(all P<0.05).Binary logistic regression analysis demonstrated that both right ventricular ejec-tion fraction(RVEF)and right ventricular systolic index(RVSI)were independent predictive factors for RVMI complicating acute inferior STEMI(all P<0.05).ROC analysis revealed that RVSI had an AUC of 0.832 with optimal cutoff of 0.37.The sensi-tivity was 83.5%and the specificity was 78.5%.RVEF showed AUC 0.881 with cutoff of 47.5%.The sensitivity was 86.9%and specificity was 82.1%.Their combination achieved superior AUC 0.918,with sensitivity of 90.4%and specificity of 87.6%.The AUC of RVEF combined with RVSI in the diagnosis of acute inferior STEMI was significantly higher than that of RVMI alone(all P<0.05).Conclusion The RT-3DE-based integrated model significantly improves diagnostic accuracy for RVMI complicating acute inferior STEMI,providing valuable evidence for early clinical intervention.
Keywords：Real-time three-dimensional echocardiographyAcute inferior ST-segment elevation myocardial infarctionRight ventricular myocardial infarctionRight ventricular sphericity indexRight ventricular ejection fraction
Publication Date：2025-06-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 38-42 )