Right atrial perfusion state should be clarified in the study targeted right atrial function in presence of right ventricular infarction

Abstract

Dear Editor I read with interest the article entitled as “Evaluation of right atrial volumes and functions by realtime threedimensional echocardiography in patients after acute inferior myocardial infarction” that published in Echocardiography; A journal of cardiovascular ultrasound and allied technique in November issue, 2018 authored by Kanar an et al.1 In this study, researchers studied right atrial function by volumetric parameters as evaluated via threedimensional echocardiography in inferior myocardial infarction patients with and without right ventricular infarction. They concluded that right atrial phasic volumes in inferior myocardial infarction patients with right ventricular infarction were increased and conduit function was decreased. Previously, Nourian et al2 assessed right atrial function by twodimensional speckle tracking echocardiography and found that reservoir and conduit function in inferior myocardial infarction patients with right ventricular infarction were decreased compared with inferior myocardial infarction patients without right ventricular infarction. These two studies were interesting because they applied advanced modalities for evaluation of right atrial function that have not been done in these patients before. But, these studies have a major drawback that should be considered in future studies. The right atrial branches perfusion state was unknown in these studies. In other words, when right ventricular infarction occurs, the perfusion of right atrium can be impaired or not. These two different state can have different effect on right atrial wall deformation and volumetric indices of right atrial function. We need a study that clarifies the perfusion state of right atrium in the presence of inferior wall and right ventricular myocardial infarction and compares the right atrial function in impaired and unimpaired right atrial perfusion. The presence of a control group such as patients with inferior myocardial infarction without right ventricular infarction will be more helpful for further clarification.