الفهرس 
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Abstract
This study aimed to assess the right ventricular function in young patients (< 40 years) with anterior ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention by speckle tracking imaging study.
It was a single center; prospective study that was conducted at the coronary care unit at ―national heart institute‖ during the period from December 2019 to April 2020.
We included 50 patients less than 40 years old presented with anterior myocardial infarction underwent successful primary PCI to LAD, compared with 15 patients diagnosed with ischemic heart disease but coronary angiography revealed no significant coronary stenosis.
Patients with history of prior MI, PCI, CABG, those had LBBB on baseline ECG, pulmonary hypertension due to valvular heart disease or lung disease, cardiomyopathy, systemic illness (renal, hepatic, malignancy), and bad echogenic window were excluded from our study.
In our study we found that The mean age in group I was 33.6 ±4.4 while in group II 33.9 ±4.9 with p value 0.41. Regarding gender distribution, there were 39 (78%) males in group I and 13 (87%) in group II with p =0.46. There were insignificant statistical differences (p > 0.05) between two groups regarding age and gender distribution (Table 4) page 59.
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The two groups were comparable regarding risk factors profile, except for dyslipidemia there was a significant statistical difference (p= 0.002) between the two groups as shown in Table 4 (page 59) and Figure 15 (page 60).
On comparing conventional echocardiographic measurements in the two studied groups, right ventricular diameters (basal, mid cavity and longitudinal) showed no statistically significant difference between studied groups as shown in Table 5 on page 64.
Statistical analysis also showed significantly decreased RV fractional area change (RV FAC) in MI group compared with control group, (P < 0.001) (Table 5 on page 64 and Figure 16 on page 61).
Regarding RV longitudinal systolic function, it was found that there were significant statistical differences between two groups in Pulsed tissue Doppler S wave (cm/s) (10.35 ± 2.08 in MI group vs. 15.27 ±1.32 in control group, p=.031)(Figure 17), (tricuspid annular early diastolic peak velocity) E‘ (cm/s) (8.99 ±1.94 in MI group vs. 14.40 ±1.32 in control group, p=.037), (tricuspid annular late diastolic peak velocity) A‘ (cm/s) (12.80 ±2.30 in MI group vs. 11.55 ±1.26 in control group, p= .029), E‘/A‘ (0.72 ± 0.20 in MI group vs. 1.25 ± 0.05 in control group, p<.001) as shown in Table 5 on page 64.
In addition, global longitudinal free wall strain (RVGLS-FW) was significantly higher in control group (-15.36 ±2.60 in MI group vs. -25.07 ±1.49 in control group, p=.006), and RV peak systolic strain rate (-1.09 ± .18 in MI group vs, -1.78 ± .10 in control group, p=.005) (Table 5 on page 64).
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Finally, RV global function assessed with tissue Doppler RV-MPI was significantly increased in MI group (0.65 ± 0.11) vs. control group (0.38 ± 0.02) with p < 0.001(Table 5 on page 64).