Right ventricular involvement in anterior myocardial infarction: a tissue Doppler-derived strain and strain rate study

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Nissl staining indicated that rat cortical cell numbers in the VF + PBS group were significantly lower than in the VF + PBS group 72 h after ROSC (A, B). 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Scattered mast cells showed an intense and granular positivity for Tβ4 (OM X250 and X 100). Adenoma with low-grade dysplasia: C) at low magnification, the diffuse cytoplasmic immunoreactivity for Tβ4 was restricted to the dysplastic crypt epithelium (OM x100); D) at higher magnification, three main patterns of reactivity for Tβ4 were observed in the dysplastic glands: perinuclear spots, cytoplasmic granules and homogeneous cytoplasmic immunostaining (OM x400); adenoma with high-grade dysplasia: E) at low magnification, intense cytoplasmic immunoreactivity for Tβ4 was observed in the cytoplasm of dysplastic cells (OMX100); F) at higher magnification, diffuse and homogeneous Tβ4 immunoreactivity was observed in the cytoplasm of dysplastic glands (OMx400); adenocarcinoma: G) at higher magnification, peri-nuclear spot-like reactivity for Tβ4 was observed in the cytoplasm of the neoplastic nest (OMx400); H) perinuclear spot-like reactivity for Tβ4 was observed in the cytoplasm of the infiltrating tumor glands. Fine granular immunoreactivity was detected in the stroma surrounding the infiltrating tumor glands (OMx250)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sonia Nemolato, Tiziana Cabras, Angelo Restivo, Luigi Zorcolo, Eliana Di Felice, Daniela Fanni, Clara Gerosa, Irene Messana, Massimo Castagnola, Gavino Faa, Giuseppe Casula" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Sonia" "apellidos" => "Nemolato" ] 1 => array:2 [ "nombre" => "Tiziana" "apellidos" => "Cabras" ] 2 => array:2 [ "nombre" => "Angelo" "apellidos" => "Restivo" ] 3 => array:2 [ "nombre" => "Luigi" "apellidos" => "Zorcolo" ] 4 => array:2 [ "nombre" => "Eliana" "apellidos" => "Di Felice" ] 5 => array:2 [ "nombre" => "Daniela" "apellidos" => "Fanni" ] 6 => array:2 [ "nombre" => "Clara" "apellidos" => "Gerosa" ] 7 => array:2 [ "nombre" => "Irene" "apellidos" => "Messana" ] 8 => array:2 [ "nombre" => "Massimo" "apellidos" => "Castagnola" ] 9 => array:2 [ "nombre" => "Gavino" "apellidos" => "Faa" ] 10 => array:2 [ "nombre" => "Giuseppe" "apellidos" => "Casula" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222016258?idApp=UINPBA00004N" "url" => "/18075932/0000006800000009/v1_202212010704/S1807593222016258/v1_202212010704/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "CLINICAL SCIENCE" "titulo" => "Right ventricular involvement in anterior myocardial infarction: a tissue Doppler-derived strain and strain rate study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1225" "paginaFinal" => "1230" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Osman Sonmez, Mehmet Kayrak, Gokhan Altunbas, Turyan Abdulhalikov, Yusuf Alihanoglu, Ahmet Bacaksiz, Kurtulus Ozdemir, Hasan Gok" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Osman" "apellidos" => "Sonmez" "email" => array:1 [ 0 => "osmansonmez2000@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "I" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Mehmet" "apellidos" => "Kayrak" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Gokhan" "apellidos" => "Altunbas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "Turyan" "apellidos" => "Abdulhalikov" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "Yusuf" "apellidos" => "Alihanoglu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "III" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "Ahmet" "apellidos" => "Bacaksiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "I" "identificador" => "aff1" ] ] ] 6 => array:3 [ "nombre" => "Kurtulus" "apellidos" => "Ozdemir" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] 7 => array:3 [ "nombre" => "Hasan" "apellidos" => "Gok" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "BezmiAlem Vakif University, Faculty of Medicine, Department of Cardiology, Istanbul/Turkey" "etiqueta" => "I" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Necmettin Erbakan University, Faculty of Medicine, Department of Cardiology, Konya/Turkey" "etiqueta" => "II" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Pamukkale University, Faculty of Medicine, Department of Cardiology, Denizli/Turkey" "etiqueta" => "III" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Tel.: 90 50 5385 8326" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig3" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 678 "Ancho" => 759 "Tamanyo" => 42713 ] ] "descripcion" => array:1 [ "en" => "Myocardial velocity, strain, and strain rate values of the basal, mid, and apical segments of the right ventricle in the control group." ] ] ] "textoCompleto" => "INTRODUCTIONAcute myocardial infarction (AMI) is characterized by a loss of contractile tissue and a change in ventricle geometry that causes substantial impairment of the right ventricle (RV) and left ventricle (LV) systolic and diastolic functions (<a class="elsevierStyleCrossRef" href="#bib1">1</a>). Currently, strain and strain rate (S/SR) imaging is the most popular echocardiographic technique for use in AMI. Tissue Doppler imaging (TDi) and S/SR imaging are the most important modalities for revealing subclinical myocardial damage (<a class="elsevierStyleCrossRef" href="#bib2">2</a>). RV involvement in inferior MI has been demonstrated via electrocardiography (ECG), clinical findings, classical TDi findings, and S/SR imaging (<a class="elsevierStyleCrossRef" href="#bib3">3</a>–<a class="elsevierStyleCrossRef" href="#bib7">7</a>). Although both subclinical damage and myocardial injury have been thoroughly investigated using other imaging modalities, such as magnetic resonance imaging (MRI) for anterior MI (<a class="elsevierStyleCrossRef" href="#bib8">8</a>–<a class="elsevierStyleCrossRef" href="#bib12">12</a>), there is currently a lack of available data associated with the S/SR imaging method. Therefore, the aim of our study was to evaluate RV regional functions using TDi-derived S/SR imaging method in patients who experienced their first successfully treated anterior MI.MATERIALS AND METHODSPatient selectionForty-four patients who had suffered their first anterior MI attack, had been hospitalized within 1–12 h of the onset of symptoms, and had undergone successful primary PCI were enrolled in the study. Bare metal stent was implanted to all patients and only TIMI-3 flow enrolled in the study, and the ethical implications regarding the study were approved by the local ethics committee. Informed consent was obtained from each patient. The patients who had a bundle branch block, a prior history of MI, percutaneous transluminal coronary angioplasty to the LAD, critical stenosis (>50%) in the right coronary artery (RCA) or circumflex coronary artery (Cx), moderate to severe valve regurgitation or stenosis, or undergone recurrent percutaneous intervention (acute stent thrombosis) were excluded from the study.Control group selectionTwenty patients between the ages of 25 and 80 years who had undergone coronary angiography in any center and had a normal coronary artery or insignificant coronary stenosis (<50%) were enrolled in the control group. The age, gender, height, weight, and coronary artery disease risk factors were recorded for each patient. Heart rate and blood pressure were also recorded at admission.Diagnostic protocolConventional tissue Doppler imagingEchocardiography was performed within the first three days following AMI. The Philips Envisor-HD11XE and 2-4-MHz phase transducer (Philips Medical Systems) were used simultaneously with ECG recordings. Conventional parameters and TDi measurements were obtained using pulsed-wave tissue Doppler imaging (PW-TDi) from the apical four-chamber view, and RV measurements were obtained from the tricuspid lateral annulus in the left lateral decubitus position. The Sm value (myocardial systolic velocity) and the Em and Am values (diastolic velocities) were recorded. The TDi-derived MPI was calculated for both LV and RV using the “(IVRT+IVCT)/ET” formula:LV MPI (TDi) = LV (IVRT+IVCT) /ET, RV MPI (TDi) = RV (IVRT+IVCT) /ETThe imaging angle was adjusted to ensure a parallel alignment of the sampling window with the myocardial segment of interest and was below 20°. The gain settings, filters, pulse repetitive frequency, sector size, and depth were adjusted to optimize color saturation. The PW-TDi spectral signal filters were adjusted to obtain a Nyquist limit of ±20 cm/s. The gain was minimized to obtain a clear signal from the tissue with the lowest possible level of background noise. The color scale was set to ≤20, and harmonics scale 2 was chosen. By aligning the appropriate color gain, the right ventricular lateral wall measurements were obtained from a maximum of 1 cm above the tricuspid annulus with PW Doppler. The sample volume of the PW Doppler (gate) was set to 0.33 cm. The sweep speed for the tissue Doppler measurements was set to 100 mm/sec, and the color scale was set to the uncolored (gray) tone. The measurements were obtained from three consecutive beats, and the mean values were recorded. The measurements were recorded while the patient was holding his/her breath at expiration. The measurements were recorded to a CD in DICOM format for subsequent analysis. The conventional echocardiographic measurements were performed based on the recommendations of the American Society of Echocardiography (<a class="elsevierStyleCrossRef" href="#bib13">13</a>,<a class="elsevierStyleCrossRef" href="#bib14">14</a>).Tissue doppler-derived strain and strain rate imagingTissue Doppler evaluation of the RV was initiated with imaging of the RV lateral wall from the apical four-chamber view. The ratio of the PW axis to the RV longitudinal axis was set to <20°. The imaging view of the right ventricular lateral wall was narrowed to increase the gain and frame rate for S/SR imaging. Angle correction was applied to all images. At least three beats were recorded for each measurement. The frame rates were set to >120 frames/sec for the colored recordings (<a class="elsevierStyleCrossRef" href="#bib15">15</a>,<a class="elsevierStyleCrossRef" href="#bib16">16</a>). All images were recorded with the following settings for strain/strain rate imaging. The RV myocardial samplings were divided between three regions, namely the RV basal, mid, and apical segments of the lateral wall. The M-mod width was set to a smaller degree than that of the right ventricular myocardium and the calculation line, with a maximum value of 1 cm (<a class="elsevierStyleCrossRef" href="#bib15">15</a>,<a class="elsevierStyleCrossRef" href="#bib16">16</a>). From these measurements, the individual myocardial velocity, strain, and strain rate values of each basal, mid, and apical segment were obtained (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>). For off-line analyses, QLab (2009) (Philips Medical Systems, compatible with the Philips Envisor HD11XE device) was used, and the recordings were made based on the mean values of these measurements.<elsevierMultimedia ident="fig1"></elsevierMultimedia>Statistical analysisThe statistical analyses were performed using SPSS (version 15.0, SPSS Inc., Chicago, IL, USA). The Kolmogorov–Smirnov test was used to evaluate whether the variables were normally distributed. The continuous variables are presented as the means±SD or as the median interquartile range. Student's t test and the chi-square test were used for comparisons of the normally distributed continuous variables and categorical variables in two groups. The Mann-Whitney U test was used for non-normally distributed variables. A p-value<0.05 was considered statistically significant.RESULTSA total of 64 patients, 44 in the patient group and 20 in the control group, were enrolled in the study. The demographic characteristics of the patients are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>. The majority of the patients were middle-aged men (mean age: 55 years). The control group was formed by performing age matching with the patient group (<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>). The baseline echocardiographic characteristics of the patients are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>. With regard to conventional echocardiographic parameters, the E/E' and RV MPi values were significantly higher in the patient group. In the analyses in which the basal, mid, and apical segments of the RV were evaluated, there was no significant difference in the conventional TDi findings between the two groups (<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>). The RV myocardial velocities and means of these values were significantly decreased with respect to all three velocities compared with the control group (5.6±1.7 and 7.1±2.3 cm/sn, p = 0.01, for the basal segment; 3.2±1.7 and 4.4±1.8 cm/sn, p = 0.03, for the mid segment; 1.5±1.2 and 2.1±0.8 cm/sn, p = 0.049, for the apical segment; 3.4±1.3 and 4.5±1.4 cm/sn, p = 0.008, for the mean values). Decreases in the RV basal segment and changes in the mean RV velocities were especially prominent in the patient group compared with the control group (<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>). The S/SR values of the RV are shown in <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>. According to these results, the S/SR values of the mid and apical RV segments in the patient group were significantly lower than those in the control group, except for the RV basal S/SR values. In addition, changes in the RV mean S/SR values were significant (−15.2±4.6 ε (%) and −22.0±4.6 ε (%), p = 0.0001, for the RV mean strain and −1.4±0.6 s−1 and −2.04±0.4 s−1, p = 0.0001, for the RV mean strain rate). While the RV basal segment S/SR values in the patient group were lower than those in the control group, this difference was not statistically significant.<elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia>DISCUSSIONThe main finding of the present study was that a significant decrease in TDi-based myocardial velocities and S/SR values of the RV has a global effect following AMi. We can conclude that, following AMi, the mid and apical RV segments are affected by LV ischemia and infarction, whereas there is no change in classical TDi findings. S/SR imaging is currently the most popular echocardiographic modality for revealing subclinical myocardial damage (<a class="elsevierStyleCrossRef" href="#bib2">2</a>,<a class="elsevierStyleCrossRef" href="#bib15">15</a>,<a class="elsevierStyleCrossRef" href="#bib16">16</a>). In the literature, postmortem studies mention RV involvement after left ventricular infarction (<a class="elsevierStyleCrossRef" href="#bib19">19</a>). Abbate et al. found RV cardiomyocyte apoptosis in patients with anteroseptal myocardial infarction and RV-free wall involvement upon histopathological examination (<a class="elsevierStyleCrossRef" href="#bib20">20</a>). Bodi et al. showed RV involvement after AMi in an animal model via MRI (<a class="elsevierStyleCrossRef" href="#bib8">8</a>). Jensen et al. revealed RV involvement after anterior STEMI in a patient via MRI, and they found that delayed RV enhancement in anterior ST-segment elevation MI is associated with a worse prognosis (<a class="elsevierStyleCrossRef" href="#bib10">10</a>).This is the first study to assess RV function after anterior STEMI using TDi-based myocardial velocity and S/SR imaging, and it adds crucial information to the literature. Although there is an abundance of classical TDi data on RV involvement after inferior Mi, few studies in the literature have obtained TDi-based S/SR measurements (<a class="elsevierStyleCrossRef" href="#bib6">6</a>–<a class="elsevierStyleCrossRef" href="#bib10">10</a>). Interestingly, in these studies, the degree of RV involvement was found to increase from the apex to the base (<a class="elsevierStyleCrossRef" href="#bib9">9</a>). In AMI, we found that RV involvement increases from the base to the apex; thus, our findings are the inverse of those for RV involvement in inferior MI (<a class="elsevierStyleCrossRef" href="#fig2">Figures 2</a>) and <a class="elsevierStyleCrossRef" href="#fig3">3</a>). Additionally, due to the current lack of available studies, it would be reasonable to wait for larger studies conducted with a greater number of patients.<elsevierMultimedia ident="fig2"></elsevierMultimedia><elsevierMultimedia ident="fig3"></elsevierMultimedia>In this study, we observed that both systolic and diastolic functions were affected after anterior STEMI. Although an increase in the LV myocardial performance index (MPI) (<a class="elsevierStyleCrossRef" href="#bib21">21</a>) and E/E' values (<a class="elsevierStyleCrossRef" href="#bib22">22</a>) is a natural consequence of an anterior MI, a significant increase in the RV MPI after anterior MI can be an important factor affecting prognosis. Symptoms and signs of RV failure after acute MI are associated with a poor prognosis and a survey of shorter than 2 years (<a class="elsevierStyleCrossRef" href="#bib23">23</a>). While investigating TDi-based increases in RV MPI after anterior STEMI, Ozturk et al. found similar increases in RV MPI (<a class="elsevierStyleCrossRef" href="#bib21">21</a>).In classical TDi studies, the RV annular velocities were lower in the patient group compared with the control group; however, this difference was not statistically significant. Alam et al. evaluated 33 patients who had experienced their first attack of anterior MI and 24 patients in a control group and reported similar findings (<a class="elsevierStyleCrossRef" href="#bib3">3</a>).One of the findings of our study involved the primary limitation of conventional TDi imaging, which has already been demonstrated in other investigations of myocardial velocities. A nonfunctional segment joined to a normally functioning segment could have normal velocities upon sampling, which complicates data interpretation (<a class="elsevierStyleCrossRef" href="#bib17">17</a>). Myocardial strains are independent of translational motion and other through-plane motion effects and are less influenced by tethering effects and overall cardiac function (<a class="elsevierStyleCrossRef" href="#bib18">18</a>). Therefore, myocardial strain data should be preferred over velocity information and could overcome this problem (<a class="elsevierStyleCrossRef" href="#bib2">2</a>,<a class="elsevierStyleCrossRef" href="#bib15">15</a>,<a class="elsevierStyleCrossRef" href="#bib16">16</a>).Finally, the findings of Abbate et al. (<a class="elsevierStyleCrossRef" href="#bib20">20</a>) may be helpful in explaining the mechanism of RV involvement. Abbate et al. showed remarkable RV cardiomyocyte apoptosis in the setting of acute myocardial infarction of the left ventricular wall. This apoptosis could be due to myocardial edema. Grothoff and Jensen et al. (<a class="elsevierStyleCrossRef" href="#bib10">10</a>,<a class="elsevierStyleCrossRef" href="#bib12">12</a>) revealed considerable edema in the RV of patients with anterior myocardial infarction in their MRI studies.The most important limitation of the study was the frame rate of TDi-based S/SR and this data was not obtained with a greater frame rate. Another limitation was the presence of an angle dependency for assessing the RV. Newer two-dimensional calculations of myocardial motion and deformation speckle tracking velocity vector imaging could overcome the angle dependency of tissue Doppler-based techniques. As long as RV geometry is non-uniform, 3D echocardiographic data are undoubtedly valuable for obtaining RV volumes and performing EF analysis. It would be valuable to obtain laboratory information, such as troponin levels, in future studies; these data could be correlated with RV dysfunction, TDi, and strain information.RV involvement following AMi was established using TDi-based S/SR imaging. According to our study results, S/SR echocardiographic evaluation of the RV may provide valuable information to aid the understanding of the pervasive nature and prognosis of the disease. RV dysfunction has also been related to poor prognosis; therefore, the function of both ventricles after AMi should be considered. RV assessment with these imaging modalities will have an increased value. However, larger studies are required to generalize the information and identify RV involvement.AUTHOR CONTRIBUTIONSSonmez O conceived and designed the study and had a large role in data analysis/interpretation, as well as in writing and editing the manuscript. Kayrak M, Altunbas G, and Abdulhalikov T performed the statistical analyses. Alihanoglu Y and Bacaksız A wrote and edited the manuscript. Ozdemir K served as a consultant and interpreted the data. Gok H served as a consultant and participated in the data interpretation and study design." "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "xpalclavsec1581238" "titulo" => "KEYWORDS" ] 1 => array:2 [ "identificador" => "cesec10" "titulo" => "INTRODUCTION" ] 2 => array:3 [ "identificador" => "cesec20" "titulo" => "MATERIALS AND METHODS" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "cesec30" "titulo" => "Patient selection" ] 1 => array:2 [ "identificador" => "cesec40" "titulo" => "Control group selection" ] 2 => array:3 [ "identificador" => "cesec50" "titulo" => "Diagnostic protocol" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "cesec60" "titulo" => "Conventional tissue Doppler imaging" ] ] ] 3 => array:2 [ "identificador" => "cesec70" "titulo" => "Tissue doppler-derived strain and strain rate imaging" ] 4 => array:2 [ "identificador" => "cesec80" "titulo" => "Statistical analysis" ] ] ] 3 => array:2 [ "identificador" => "cesec90" "titulo" => "RESULTS" ] 4 => array:2 [ "identificador" => "cesec100" "titulo" => "DISCUSSION" ] 5 => array:2 [ "identificador" => "cesec110" "titulo" => "AUTHOR CONTRIBUTIONS" ] 6 => array:2 [ "identificador" => "xack638799" "titulo" => "ACKNOWLEDGMENTS" ] 7 => array:1 [ "titulo" => "REFERENCES" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-05-10" "fechaAceptado" => "2013-07-16" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec1581238" "palabras" => array:5 [ 0 => "Right Ventricle" 1 => "Involvement" 2 => "Strain/Strain Rate" 3 => "Doppler" 4 => "Anterior Myocardial Infarction" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "OBJECTIVEStrain and strain rate imaging is currently the most popular echocardiographic technique that reveals subclinical myocardial damage. There are currently no available data on this imaging method with regard to assessing right ventricular involvement in anterior myocardial infarction. Therefore, we aimed to evaluate right ventricular regional functions using a derived strain and strain rate imaging tissue Doppler method in patients who were successfully treated for their first anterior myocardial infarction. METHODSThe patient group was composed of 44 patients who had experienced their first anterior myocardial infarction and had undergone successful percutaneous coronary intervention. Twenty patients were selected for the control group. The right ventricular myocardial samplings were performed in three regions: the basal, mid, and apical segments of the lateral wall. The individual myocardial velocity, strain, and strain rate values of each basal, mid, and apical segment were obtained. RESULTSThe right ventricular myocardial velocities of the patient group were significantly decreased with respect to all three velocities in the control group. The strain and strain rate values of the right mid and apical ventricular segments in the patient group were significantly lower than those of the control group (excluding the right ventricular basal strain and strain rate). In addition, changes in the right ventricular mean strain and strain rate values were significant. CONCLUSIONRight ventricular involvement following anterior myocardial infarction can be assessed using tissue Doppler based strain and strain rate" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "OBJECTIVE" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "METHODS" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "RESULTS" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "CONCLUSION" ] ] ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "No potential conflict of interest was reported." ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 562 "Ancho" => 747 "Tamanyo" => 71279 ] ] "descripcion" => array:1 [ "en" => "A) Myocardial velocities associated with the basal, mid, and apical segments of the right ventricle. B) Myocardial deformation curves associated with the basal, mid, and apical segments of the right ventricle. C) Strain curve of the mid segment of the right ventricle. D) Strain rate curve of the mid segment of the right ventricle." ] ] 1 => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 801 "Ancho" => 759 "Tamanyo" => 48650 ] ] "descripcion" => array:1 [ "en" => "Myocardial velocity, strain, and strain rate values of the basal, mid, and apical segments of the right ventricle showing RV involvement from the base to the apex in Ami patients." ] ] 2 => array:7 [ "identificador" => "fig3" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 678 "Ancho" => 759 "Tamanyo" => 42713 ] ] "descripcion" => array:1 [ "en" => "Myocardial velocity, strain, and strain rate values of the basal, mid, and apical segments of the right ventricle in the control group." ] ] 3 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "LVEF: Left Ventricular Ejection Fraction, LVEDD: Left Ventricular End Diastolic Diameter, LVESD: Left Ventricular End Systolic Diameter, RV: Right Ventricle, MPi: Myocardial Performance Index, NS: Not Significant, PSAP: Pulmonary Systolic Arterial Pressure. The chi-square and Student's t tests were used." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="justify" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Patient Group \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Control Group \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="justify" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">N = 44 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">N = 20 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Patient characteristics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Age (years) mean ± SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">55±13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">55±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Female / Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">8/36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">4/15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Body mass index (BMi)(kg/m2) mean ± SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">28.1±4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">27.1±3.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Medical history n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Current smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">15 (35%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">7 (43%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">13(30%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">6(33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">10(21%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">4 (23%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Heredity for Coronary artery disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">6(14%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">2 (11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Hemodynamics mean ± SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Blood Pressure (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Systolic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">106±10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">105±9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Diastolic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">69±6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">68±5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Heart rate (beats/min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">78±11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">76±10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Conventional echocardiography mean ± SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">LVEF Mean (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">42.8±8.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">64±4.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">LVEDD (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">4.7±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">4.5±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">LVESD (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">3.0±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">2.9±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">LV Mass (gr) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Mitral E/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">1.05±0.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.90±0.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.130 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Tricuspid E/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">1.00±0.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.96±0.32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.740 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">E/E' \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">8.0 (7.1–9.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">6.3 (5.0–7.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.001<a class="elsevierStyleCrossRef" href="#TFN02t01">∗</a>) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">MPi RV conventional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.32±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.24±0.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.015 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">MPi RV TDi \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.55±0.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.40±0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">PSAP (mmhg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">27±6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">26±4.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "TFN02t01" "etiqueta" => "∗" "nota" => "Mann Whitney U test." ] ] ] "descripcion" => array:1 [ "en" => "Baseline patient characteristics." ] ] 4 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "RV: Right Ventricle, MPi: Myocardial Performance Index, TDi: Tissue Doppler Imaging, Sm: Systolic Motion, Em: Early Motion, Am: Atrial Motion." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="justify" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Patient Group \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Control Group \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="justify" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">N = 44 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">N = 19 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Tissue Doppler-derived S/SR mean ± SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV velocity basal systolic V (cm/sm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">5.6±1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">7.1±2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV velocity mid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">3.2±1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">4.4±1.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.030 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV velocity apical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">1.5±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">2.1±0.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.010 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV velocity mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">3.4±1.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">4.5±1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV E mean diastolic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">2.9±1.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">2.9±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.234 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV A mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">2.4±1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">3.0±1.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.116 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain basal ε (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−21.4±6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−24.6±5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.101 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain mid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−15.8±6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−22.0±5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain apical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−8.6±5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−19.5±5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−15.2±4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−22.0±4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain rate basal (s−1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−1.9±0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">−2.02±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.622 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain rate mid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−1.4±0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−2.3±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0,0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain rate apical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−0.8±0.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−1.8±0.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0,0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV strain rate mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">−1.4±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">−2.04±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0,0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">Conventional TDi Findings mean ± SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV Sm TDi Systolic V (cm/sn) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">12.3±2.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">13.1±2.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV Em TDi diastolic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">10.1±2.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="top">10.4±2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.360 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="justify" valign="top">RV Am TDİ diastolic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">7.24±2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">7.78±.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">0.880 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Tissue Doppler and Strain/Strain Rate Findings." ] ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" 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""" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCIMAGING.111.967810" "Revista" => array:7 [ "tituloSerie" => "Circ Cardiovasc Imaging" "fecha" => "2012" "volumen" => "5" "numero" => "1" "paginaInicial" => "60" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22080332" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendations for quantitation of the left ventricle by 2-dimensional echocardiography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ NB Schiller \n \t\t\t\t\t\t\t\t """ 1 => """ PM Shah \n \t\t\t\t\t\t\t\t """ 2 => """ M Crawford \n \t\t\t\t\t\t\t\t """ 3 => """ A DeMaria \n \t\t\t\t\t\t\t\t """ 4 => """ R Devereux \n \t\t\t\t\t\t\t\t """ 5 => """ H Feigenbaum \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 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array:2 [ "etal" => true "autores" => array:6 [ 0 => """ A Abbate \n \t\t\t\t\t\t\t\t """ 1 => """ R Bussani \n \t\t\t\t\t\t\t\t """ 2 => """ G Sinagra \n \t\t\t\t\t\t\t\t """ 3 => """ E Barresi \n \t\t\t\t\t\t\t\t """ 4 => """ A Pivetta \n \t\t\t\t\t\t\t\t """ 5 => """ A Perkan \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2008.05.007" "Revista" => array:7 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2008" "volumen" => "102" "numero" => "6" "paginaInicial" => "658" "paginaFinal" => "662" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18773983" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of angiotensin-converting enzyme I/D gene polymorphism on the right ventricular myocardial performance index in patients with a first acute anterior myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ O Ozturk \n \t\t\t\t\t\t\t\t """ 1 => """ MS Ulgen \n \t\t\t\t\t\t\t\t """ 2 => """ S Tekes \n \t\t\t\t\t\t\t\t """ 3 => """ U Ozturk \n \t\t\t\t\t\t\t\t """ 4 => """ N Toprak \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2005" "volumen" => "69" "numero" => "2" "paginaInicial" => "211" "paginaFinal" => "215" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic importance of diastolic function and filling pressure in patients with acute myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ JE M⊘ller \n \t\t\t\t\t\t\t\t """ 1 => """ PA Pellikka \n \t\t\t\t\t\t\t\t """ 2 => """ GS Hillis \n \t\t\t\t\t\t\t\t """ 3 => """ JK Oh \n 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"Revista" => array:7 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1995" "volumen" => "25" "numero" => "5" "paginaInicial" => "1143" "paginaFinal" => "1153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7897128" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack638799" "titulo" => "ACKNOWLEDGMENTS" "texto" => "The authors express their thanks to the staff of the Department of Cardiology, Faculty of Medicine Hospital, Necmettin Erbakan University, Konya, Turkey, for their kind cooperation with this study. There were no sources (e.g., grants, equipment, drugs, or a combination of any of these sources) of support for this work." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/0000006800000009/v1_202212010704/S180759322201626X/v1_202212010704/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006800000009/v1_202212010704/S180759322201626X/v1_202212010704/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S180759322201626X?idApp=UINPBA00004N"]

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CLINICAL SCIENCE

Osman SonmezI,

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osmansonmez2000@gmail.com

Tel.: 90 50 5385 8326

, Mehmet KayrakII, Gokhan AltunbasII, Turyan AbdulhalikovII, Yusuf AlihanogluIII, Ahmet BacaksizI, Kurtulus OzdemirII, Hasan GokII

I BezmiAlem Vakif University, Faculty of Medicine, Department of Cardiology, Istanbul/Turkey

II Necmettin Erbakan University, Faculty of Medicine, Department of Cardiology, Konya/Turkey

III Pamukkale University, Faculty of Medicine, Department of Cardiology, Denizli/Turkey

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    "titulo" => "Right ventricular involvement in anterior myocardial infarction&#58; a tissue Doppler-derived strain and strain rate study"
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          "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Myocardial velocity&#44; strain&#44; and strain rate values of the basal&#44; mid&#44; and apical segments of the right ventricle in the control group&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Acute myocardial infarction &#40;AMI&#41; is characterized by a loss of contractile tissue and a change in ventricle geometry that causes substantial impairment of the right ventricle &#40;RV&#41; and left ventricle &#40;LV&#41; systolic and diastolic functions &#40;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#41;&#46; Currently&#44; strain and strain rate &#40;S&#47;SR&#41; imaging is the most popular echocardiographic technique for use in AMI&#46; Tissue Doppler imaging &#40;TDi&#41; and S&#47;SR imaging are the most important modalities for revealing subclinical myocardial damage &#40;<a class="elsevierStyleCrossRef" href="#bib2">2</a>&#41;&#46; RV involvement in inferior MI has been demonstrated via electrocardiography &#40;ECG&#41;&#44; clinical findings&#44; classical TDi findings&#44; and S&#47;SR imaging &#40;<a class="elsevierStyleCrossRef" href="#bib3">3</a>&#8211;<a class="elsevierStyleCrossRef" href="#bib7">7</a>&#41;&#46; Although both subclinical damage and myocardial injury have been thoroughly investigated using other imaging modalities&#44; such as magnetic resonance imaging &#40;MRI&#41; for anterior MI &#40;<a class="elsevierStyleCrossRef" href="#bib8">8</a>&#8211;<a class="elsevierStyleCrossRef" href="#bib12">12</a>&#41;&#44; there is currently a lack of available data associated with the S&#47;SR imaging method&#46; Therefore&#44; the aim of our study was to evaluate RV regional functions using TDi-derived S&#47;SR imaging method in patients who experienced their first successfully treated anterior MI&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">MATERIALS AND METHODS</span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">Patient selection</span><p id="para20" class="elsevierStylePara elsevierViewall">Forty-four patients who had suffered their first anterior MI attack&#44; had been hospitalized within 1&#8211;12 h of the onset of symptoms&#44; and had undergone successful primary PCI were enrolled in the study&#46; Bare metal stent was implanted to all patients and only TIMI-3 flow enrolled in the study&#44; and the ethical implications regarding the study were approved by the local ethics committee&#46; Informed consent was obtained from each patient&#46; The patients who had a bundle branch block&#44; a prior history of MI&#44; percutaneous transluminal coronary angioplasty to the LAD&#44; critical stenosis &#40;&#62;50&#37;&#41; in the right coronary artery &#40;RCA&#41; or circumflex coronary artery &#40;Cx&#41;&#44; moderate to severe valve regurgitation or stenosis&#44; or undergone recurrent percutaneous intervention &#40;acute stent thrombosis&#41; were excluded from the study&#46;</p></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Control group selection</span><p id="para30" class="elsevierStylePara elsevierViewall">Twenty patients between the ages of 25 and 80 years who had undergone coronary angiography in any center and had a normal coronary artery or insignificant coronary stenosis &#40;&#60;50&#37;&#41; were enrolled in the control group&#46; The age&#44; gender&#44; height&#44; weight&#44; and coronary artery disease risk factors were recorded for each patient&#46; Heart rate and blood pressure were also recorded at admission&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Diagnostic protocol</span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle110">Conventional tissue Doppler imaging</span><p id="para40" class="elsevierStylePara elsevierViewall">Echocardiography was performed within the first three days following AMI&#46; The Philips Envisor-HD11XE and 2-4-MHz phase transducer &#40;Philips Medical Systems&#41; were used simultaneously with ECG recordings&#46; Conventional parameters and TDi measurements were obtained using pulsed-wave tissue Doppler imaging &#40;PW-TDi&#41; from the apical four-chamber view&#44; and RV measurements were obtained from the tricuspid lateral annulus in the left lateral decubitus position&#46; The Sm value &#40;myocardial systolic velocity&#41; and the Em and Am values &#40;diastolic velocities&#41; were recorded&#46; The TDi-derived MPI was calculated for both LV and RV using the &#8220;&#40;IVRT&#43;IVCT&#41;&#47;ET&#8221; formula&#58;</p><p id="para50" class="elsevierStylePara elsevierViewall">LV MPI &#40;TDi&#41; &#61; LV &#40;IVRT&#43;IVCT&#41; &#47;ET&#44; RV MPI &#40;TDi&#41; &#61; RV &#40;IVRT&#43;IVCT&#41; &#47;ET</p><p id="para60" class="elsevierStylePara elsevierViewall">The imaging angle was adjusted to ensure a parallel alignment of the sampling window with the myocardial segment of interest and was below 20&#176;&#46; The gain settings&#44; filters&#44; pulse repetitive frequency&#44; sector size&#44; and depth were adjusted to optimize color saturation&#46; The PW-TDi spectral signal filters were adjusted to obtain a Nyquist limit of &#177;20 cm&#47;s&#46; The gain was minimized to obtain a clear signal from the tissue with the lowest possible level of background noise&#46; The color scale was set to &#8804;20&#44; and harmonics scale 2 was chosen&#46; By aligning the appropriate color gain&#44; the right ventricular lateral wall measurements were obtained from a maximum of 1 cm above the tricuspid annulus with PW Doppler&#46; The sample volume of the PW Doppler &#40;gate&#41; was set to 0&#46;33 cm&#46; The sweep speed for the tissue Doppler measurements was set to 100 mm&#47;sec&#44; and the color scale was set to the uncolored &#40;gray&#41; tone&#46; The measurements were obtained from three consecutive beats&#44; and the mean values were recorded&#46; The measurements were recorded while the patient was holding his&#47;her breath at expiration&#46; The measurements were recorded to a CD in DICOM format for subsequent analysis&#46; The conventional echocardiographic measurements were performed based on the recommendations of the American Society of Echocardiography &#40;<a class="elsevierStyleCrossRef" href="#bib13">13</a>&#44;<a class="elsevierStyleCrossRef" href="#bib14">14</a>&#41;&#46;</p></span></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle120">Tissue doppler-derived strain and strain rate imaging</span><p id="para70" class="elsevierStylePara elsevierViewall">Tissue Doppler evaluation of the RV was initiated with imaging of the RV lateral wall from the apical four-chamber view&#46; The ratio of the PW axis to the RV longitudinal axis was set to &#60;20&#176;&#46; The imaging view of the right ventricular lateral wall was narrowed to increase the gain and frame rate for S&#47;SR imaging&#46; Angle correction was applied to all images&#46; At least three beats were recorded for each measurement&#46; The frame rates were set to &#62;120 frames&#47;sec for the colored recordings &#40;<a class="elsevierStyleCrossRef" href="#bib15">15</a>&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a>&#41;&#46; All images were recorded with the following settings for strain&#47;strain rate imaging&#46; The RV myocardial samplings were divided between three regions&#44; namely the RV basal&#44; mid&#44; and apical segments of the lateral wall&#46; The M-mod width was set to a smaller degree than that of the right ventricular myocardium and the calculation line&#44; with a maximum value of 1 cm &#40;<a class="elsevierStyleCrossRef" href="#bib15">15</a>&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a>&#41;&#46; From these measurements&#44; the individual myocardial velocity&#44; strain&#44; and strain rate values of each basal&#44; mid&#44; and apical segment were obtained &#40;<a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#41;&#46; For off-line analyses&#44; QLab &#40;2009&#41; &#40;Philips Medical Systems&#44; compatible with the Philips Envisor HD11XE device&#41; was used&#44; and the recordings were made based on the mean values of these measurements&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">Statistical analysis</span><p id="para80" class="elsevierStylePara elsevierViewall">The statistical analyses were performed using SPSS &#40;version 15&#46;0&#44; SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46; The Kolmogorov&#8211;Smirnov test was used to evaluate whether the variables were normally distributed&#46; The continuous variables are presented as the means&#177;SD or as the median interquartile range&#46; Student&#39;s t test and the chi-square test were used for comparisons of the normally distributed continuous variables and categorical variables in two groups&#46; The Mann-Whitney U test was used for non-normally distributed variables&#46; A <span class="elsevierStyleItalic">p</span>-value&#60;0&#46;05 was considered statistically significant&#46;</p></span></span><span id="cesec90" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">RESULTS</span><p id="para90" class="elsevierStylePara elsevierViewall">A total of 64 patients&#44; 44 in the patient group and 20 in the control group&#44; were enrolled in the study&#46; The demographic characteristics of the patients are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#46; The majority of the patients were middle-aged men &#40;mean age&#58; 55 years&#41;&#46; The control group was formed by performing age matching with the patient group &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46; The baseline echocardiographic characteristics of the patients are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#46; With regard to conventional echocardiographic parameters&#44; the E&#47;E&#39; and RV MPi values were significantly higher in the patient group&#46; In the analyses in which the basal&#44; mid&#44; and apical segments of the RV were evaluated&#44; there was no significant difference in the conventional TDi findings between the two groups &#40;<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46; The RV myocardial velocities and means of these values were significantly decreased with respect to all three velocities compared with the control group &#40;5&#46;6&#177;1&#46;7 and 7&#46;1&#177;2&#46;3 cm&#47;sn&#44; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;01&#44; for the basal segment&#59; 3&#46;2&#177;1&#46;7 and 4&#46;4&#177;1&#46;8 cm&#47;sn&#44; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;03&#44; for the mid segment&#59; 1&#46;5&#177;1&#46;2 and 2&#46;1&#177;0&#46;8 cm&#47;sn&#44; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;049&#44; for the apical segment&#59; 3&#46;4&#177;1&#46;3 and 4&#46;5&#177;1&#46;4 cm&#47;sn&#44; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;008&#44; for the mean values&#41;&#46; Decreases in the RV basal segment and changes in the mean RV velocities were especially prominent in the patient group compared with the control group &#40;<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46; The S&#47;SR values of the RV are shown in <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#46; According to these results&#44; the S&#47;SR values of the mid and apical RV segments in the patient group were significantly lower than those in the control group&#44; except for the RV basal S&#47;SR values&#46; In addition&#44; changes in the RV mean S&#47;SR values were significant &#40;&#8722;15&#46;2&#177;4&#46;6 <span class="elsevierStyleItalic">&#949; &#40;&#37;&#41;</span> and &#8722;22&#46;0&#177;4&#46;6 <span class="elsevierStyleItalic">&#949; &#40;&#37;&#41;</span>&#44; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;0001&#44; for the RV mean strain and &#8722;1&#46;4&#177;0&#46;6 <span class="elsevierStyleItalic">s<span class="elsevierStyleSup">&#8722;1</span></span> and &#8722;2&#46;04&#177;0&#46;4 <span class="elsevierStyleItalic">s<span class="elsevierStyleSup">&#8722;1</span></span>&#44; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;0001&#44; for the RV mean strain rate&#41;&#46; While the RV basal segment S&#47;SR values in the patient group were lower than those in the control group&#44; this difference was not statistically significant&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia></span><span id="cesec100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">DISCUSSION</span><p id="para100" class="elsevierStylePara elsevierViewall">The main finding of the present study was that a significant decrease in TDi-based myocardial velocities and S&#47;SR values of the RV has a global effect following AMi&#46; We can conclude that&#44; following AMi&#44; the mid and apical RV segments are affected by LV ischemia and infarction&#44; whereas there is no change in classical TDi findings&#46; S&#47;SR imaging is currently the most popular echocardiographic modality for revealing subclinical myocardial damage &#40;<a class="elsevierStyleCrossRef" href="#bib2">2</a>&#44;<a class="elsevierStyleCrossRef" href="#bib15">15</a>&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a>&#41;&#46; In the literature&#44; postmortem studies mention RV involvement after left ventricular infarction &#40;<a class="elsevierStyleCrossRef" href="#bib19">19</a>&#41;&#46; Abbate et al&#46; found RV cardiomyocyte apoptosis in patients with anteroseptal myocardial infarction and RV-free wall involvement upon histopathological examination &#40;<a class="elsevierStyleCrossRef" href="#bib20">20</a>&#41;&#46; Bodi et al&#46; showed RV involvement after AMi in an animal model via MRI &#40;<a class="elsevierStyleCrossRef" href="#bib8">8</a>&#41;&#46; Jensen et al&#46; revealed RV involvement after anterior STEMI in a patient via MRI&#44; and they found that delayed RV enhancement in anterior ST-segment elevation MI is associated with a worse prognosis &#40;<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#41;&#46;</p><p id="para110" class="elsevierStylePara elsevierViewall">This is the first study to assess RV function after anterior STEMI using TDi-based myocardial velocity and S&#47;SR imaging&#44; and it adds crucial information to the literature&#46; Although there is an abundance of classical TDi data on RV involvement after inferior Mi&#44; few studies in the literature have obtained TDi-based S&#47;SR measurements &#40;<a class="elsevierStyleCrossRef" href="#bib6">6</a>&#8211;<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#41;&#46; Interestingly&#44; in these studies&#44; the degree of RV involvement was found to increase from the apex to the base &#40;<a class="elsevierStyleCrossRef" href="#bib9">9</a>&#41;&#46; In AMI&#44; we found that RV involvement increases from the base to the apex&#59; thus&#44; our findings are the inverse of those for RV involvement in inferior MI &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figures 2</a>&#41; and <a class="elsevierStyleCrossRef" href="#fig3">3</a>&#41;&#46; Additionally&#44; due to the current lack of available studies&#44; it would be reasonable to wait for larger studies conducted with a greater number of patients&#46;</p><elsevierMultimedia ident="fig2"></elsevierMultimedia><elsevierMultimedia ident="fig3"></elsevierMultimedia><p id="para120" class="elsevierStylePara elsevierViewall">In this study&#44; we observed that both systolic and diastolic functions were affected after anterior STEMI&#46; Although an increase in the LV myocardial performance index &#40;MPI&#41; &#40;<a class="elsevierStyleCrossRef" href="#bib21">21</a>&#41; and E&#47;E&#39; values &#40;<a class="elsevierStyleCrossRef" href="#bib22">22</a>&#41; is a natural consequence of an anterior MI&#44; a significant increase in the RV MPI after anterior MI can be an important factor affecting prognosis&#46; Symptoms and signs of RV failure after acute MI are associated with a poor prognosis and a survey of shorter than 2 years &#40;<a class="elsevierStyleCrossRef" href="#bib23">23</a>&#41;&#46; While investigating TDi-based increases in RV MPI after anterior STEMI&#44; Ozturk et al&#46; found similar increases in RV MPI &#40;<a class="elsevierStyleCrossRef" href="#bib21">21</a>&#41;&#46;</p><p id="para130" class="elsevierStylePara elsevierViewall">In classical TDi studies&#44; the RV annular velocities were lower in the patient group compared with the control group&#59; however&#44; this difference was not statistically significant&#46; Alam et al&#46; evaluated 33 patients who had experienced their first attack of anterior MI and 24 patients in a control group and reported similar findings &#40;<a class="elsevierStyleCrossRef" href="#bib3">3</a>&#41;&#46;</p><p id="para140" class="elsevierStylePara elsevierViewall">One of the findings of our study involved the primary limitation of conventional TDi imaging&#44; which has already been demonstrated in other investigations of myocardial velocities&#46; A nonfunctional segment joined to a normally functioning segment could have normal velocities upon sampling&#44; which complicates data interpretation &#40;<a class="elsevierStyleCrossRef" href="#bib17">17</a>&#41;&#46; Myocardial strains are independent of translational motion and other through-plane motion effects and are less influenced by tethering effects and overall cardiac function &#40;<a class="elsevierStyleCrossRef" href="#bib18">18</a>&#41;&#46; Therefore&#44; myocardial strain data should be preferred over velocity information and could overcome this problem &#40;<a class="elsevierStyleCrossRef" href="#bib2">2</a>&#44;<a class="elsevierStyleCrossRef" href="#bib15">15</a>&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a>&#41;&#46;</p><p id="para150" class="elsevierStylePara elsevierViewall">Finally&#44; the findings of Abbate et al&#46; &#40;<a class="elsevierStyleCrossRef" href="#bib20">20</a>&#41; may be helpful in explaining the mechanism of RV involvement&#46; Abbate et al&#46; showed remarkable RV cardiomyocyte apoptosis in the setting of acute myocardial infarction of the left ventricular wall&#46; This apoptosis could be due to myocardial edema&#46; Grothoff and Jensen et al&#46; &#40;<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#44;<a class="elsevierStyleCrossRef" href="#bib12">12</a>&#41; revealed considerable edema in the RV of patients with anterior myocardial infarction in their MRI studies&#46;</p><p id="para160" class="elsevierStylePara elsevierViewall">The most important limitation of the study was the frame rate of TDi-based S&#47;SR and this data was not obtained with a greater frame rate&#46; Another limitation was the presence of an angle dependency for assessing the RV&#46; Newer two-dimensional calculations of myocardial motion and deformation speckle tracking velocity vector imaging could overcome the angle dependency of tissue Doppler-based techniques&#46; As long as RV geometry is non-uniform&#44; 3D echocardiographic data are undoubtedly valuable for obtaining RV volumes and performing EF analysis&#46; It would be valuable to obtain laboratory information&#44; such as troponin levels&#44; in future studies&#59; these data could be correlated with RV dysfunction&#44; TDi&#44; and strain information&#46;</p><p id="para170" class="elsevierStylePara elsevierViewall">RV involvement following AMi was established using TDi-based S&#47;SR imaging&#46; According to our study results&#44; S&#47;SR echocardiographic evaluation of the RV may provide valuable information to aid the understanding of the pervasive nature and prognosis of the disease&#46; RV dysfunction has also been related to poor prognosis&#59; therefore&#44; the function of both ventricles after AMi should be considered&#46; RV assessment with these imaging modalities will have an increased value&#46; However&#44; larger studies are required to generalize the information and identify RV involvement&#46;</p></span><span id="cesec110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">AUTHOR CONTRIBUTIONS</span><p id="para180" class="elsevierStylePara elsevierViewall">Sonmez O conceived and designed the study and had a large role in data analysis&#47;interpretation&#44; as well as in writing and editing the manuscript&#46; Kayrak M&#44; Altunbas G&#44; and Abdulhalikov T performed the statistical analyses&#46; Alihanoglu Y and Bacaks&#305;z A wrote and edited the manuscript&#46; Ozdemir K served as a consultant and interpreted the data&#46; Gok H served as a consultant and participated in the data interpretation and study design&#46;</p></span></span>"
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          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        2 => array:3 [
          "identificador" => "cesec20"
          "titulo" => "MATERIALS AND METHODS"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "cesec30"
              "titulo" => "Patient selection"
            ]
            1 => array:2 [
              "identificador" => "cesec40"
              "titulo" => "Control group selection"
            ]
            2 => array:3 [
              "identificador" => "cesec50"
              "titulo" => "Diagnostic protocol"
              "secciones" => array:1 [
                0 => array:2 [
                  "identificador" => "cesec60"
                  "titulo" => "Conventional tissue Doppler imaging"
                ]
              ]
            ]
            3 => array:2 [
              "identificador" => "cesec70"
              "titulo" => "Tissue doppler-derived strain and strain rate imaging"
            ]
            4 => array:2 [
              "identificador" => "cesec80"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "cesec90"
          "titulo" => "RESULTS"
        ]
        4 => array:2 [
          "identificador" => "cesec100"
          "titulo" => "DISCUSSION"
        ]
        5 => array:2 [
          "identificador" => "cesec110"
          "titulo" => "AUTHOR CONTRIBUTIONS"
        ]
        6 => array:2 [
          "identificador" => "xack638799"
          "titulo" => "ACKNOWLEDGMENTS"
        ]
        7 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-05-10"
    "fechaAceptado" => "2013-07-16"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec1581238"
          "palabras" => array:5 [
            0 => "Right Ventricle"
            1 => "Involvement"
            2 => "Strain&#47;Strain Rate"
            3 => "Doppler"
            4 => "Anterior Myocardial Infarction"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">OBJECTIVE</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">Strain and strain rate imaging is currently the most popular echocardiographic technique that reveals subclinical myocardial damage&#46; There are currently no available data on this imaging method with regard to assessing right ventricular involvement in anterior myocardial infarction&#46; Therefore&#44; we aimed to evaluate right ventricular regional functions using a derived strain and strain rate imaging tissue Doppler method in patients who were successfully treated for their first anterior myocardial infarction&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">The patient group was composed of 44 patients who had experienced their first anterior myocardial infarction and had undergone successful percutaneous coronary intervention&#46; Twenty patients were selected for the control group&#46; The right ventricular myocardial samplings were performed in three regions&#58; the basal&#44; mid&#44; and apical segments of the lateral wall&#46; The individual myocardial velocity&#44; strain&#44; and strain rate values of each basal&#44; mid&#44; and apical segment were obtained&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">The right ventricular myocardial velocities of the patient group were significantly decreased with respect to all three velocities in the control group&#46; The strain and strain rate values of the right mid and apical ventricular segments in the patient group were significantly lower than those of the control group &#40;excluding the right ventricular basal strain and strain rate&#41;&#46; In addition&#44; changes in the right ventricular mean strain and strain rate values were significant&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSION</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">Right ventricular involvement following anterior myocardial infarction can be assessed using tissue Doppler based strain and strain rate</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "ceabs10"
            "titulo" => "OBJECTIVE"
          ]
          1 => array:2 [
            "identificador" => "ceabs20"
            "titulo" => "METHODS"
          ]
          2 => array:2 [
            "identificador" => "ceabs30"
            "titulo" => "RESULTS"
          ]
          3 => array:2 [
            "identificador" => "ceabs40"
            "titulo" => "CONCLUSION"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="cenpara20">No potential conflict of interest was reported&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 562
            "Ancho" => 747
            "Tamanyo" => 71279
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">A&#41;</span> Myocardial velocities associated with the basal&#44; mid&#44; and apical segments of the right ventricle&#46; <span class="elsevierStyleBold">B&#41;</span> Myocardial deformation curves associated with the basal&#44; mid&#44; and apical segments of the right ventricle&#46; <span class="elsevierStyleBold">C&#41;</span> Strain curve of the mid segment of the right ventricle&#46; <span class="elsevierStyleBold">D&#41;</span> Strain rate curve of the mid segment of the right ventricle&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig2"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 801
            "Ancho" => 759
            "Tamanyo" => 48650
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Myocardial velocity&#44; strain&#44; and strain rate values of the basal&#44; mid&#44; and apical segments of the right ventricle showing RV involvement from the base to the apex in Ami patients&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig3"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 678
            "Ancho" => 759
            "Tamanyo" => 42713
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Myocardial velocity&#44; strain&#44; and strain rate values of the basal&#44; mid&#44; and apical segments of the right ventricle in the control group&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="TFN01t01" class="elsevierStyleSimplePara elsevierViewall">LVEF&#58; Left Ventricular Ejection Fraction&#44; LVEDD&#58; Left Ventricular End Diastolic Diameter&#44; LVESD&#58; Left Ventricular End Systolic Diameter&#44; RV&#58; Right Ventricle&#44; MPi&#58; Myocardial Performance Index&#44; NS&#58; Not Significant&#44; PSAP&#58; Pulmonary Systolic Arterial Pressure&#46; The chi-square and Student&#39;s t tests were used&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="justify" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Patient Group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Control Group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="justify" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">N &#61; 44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">N &#61; 20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top"><span class="elsevierStyleBold">Patient characteristics</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Age &#40;years&#41; mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">55&#177;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">55&#177;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Female &#47; Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#47;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#47;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Body mass index &#40;BMi&#41;&#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41; mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">28&#46;1&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">27&#46;1&#177;3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top"><span class="elsevierStyleBold">Medical history n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Current smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">15 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7 &#40;43&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">13&#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">10&#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Heredity for Coronary artery disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top"><span class="elsevierStyleBold">Hemodynamics</span> mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Blood Pressure &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Systolic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">106&#177;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">105&#177;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Diastolic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">69&#177;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">68&#177;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Heart rate &#40;beats&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">78&#177;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">76&#177;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top"><span class="elsevierStyleBold">Conventional echocardiography</span> mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">LVEF Mean &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">42&#46;8&#177;8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">64&#177;4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">LVEDD &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#46;7&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#46;5&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">LVESD &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#46;0&#177;0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#46;9&#177;0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">LV Mass &#40;gr&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Mitral E&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&#46;05&#177;0&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;90&#177;0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">Tricuspid E&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&#46;00&#177;0&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;96&#177;0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;740&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">E&#47;E&#39;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#46;0 &#40;7&#46;1&#8211;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#46;3 &#40;5&#46;0&#8211;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;001<a class="elsevierStyleCrossRef" href="#TFN02t01">&#8727;</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">MPi RV conventional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;32&#177;0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;24&#177;0&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">MPi RV TDi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;55&#177;0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;40&#177;0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">PSAP &#40;mmhg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">27&#177;6&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">26&#177;4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "TFN02t01"
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          "leyenda" => "<p id="TFN01t03" class="elsevierStyleSimplePara elsevierViewall">RV&#58; Right Ventricle&#44; MPi&#58; Myocardial Performance Index&#44; TDi&#58; Tissue Doppler Imaging&#44; Sm&#58; Systolic Motion&#44; Em&#58; Early Motion&#44; Am&#58; Atrial Motion&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="justify" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Patient Group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Control Group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="justify" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">N &#61; 44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">N &#61; 19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top"><span class="elsevierStyleBold">Tissue Doppler-derived S&#47;SR</span> mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV velocity basal systolic V <span class="elsevierStyleItalic">&#40;cm&#47;sm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">5&#46;6&#177;1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">7&#46;1&#177;2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV velocity mid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">3&#46;2&#177;1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">4&#46;4&#177;1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;030&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV velocity apical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">1&#46;5&#177;1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">2&#46;1&#177;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV velocity mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">3&#46;4&#177;1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">4&#46;5&#177;1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV E mean diastolic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">2&#46;9&#177;1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">2&#46;9&#177;1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV A mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">2&#46;4&#177;1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">3&#46;0&#177;1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain basal <span class="elsevierStyleItalic">&#949; &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;21&#46;4&#177;6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;24&#46;6&#177;5&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain mid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;15&#46;8&#177;6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;22&#46;0&#177;5&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain apical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;8&#46;6&#177;5&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;19&#46;5&#177;5&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;15&#46;2&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;22&#46;0&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain rate basal <span class="elsevierStyleItalic">&#40;<span class="elsevierStyleBold">s<span class="elsevierStyleSup">&#8722;1</span></span>&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;1&#46;9&#177;0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">&#8722;2&#46;02&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain rate mid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;1&#46;4&#177;0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;2&#46;3&#177;0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain rate apical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;8&#177;0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;1&#46;8&#177;0&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV strain rate mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;1&#46;4&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">&#8722;2&#46;04&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top"><span class="elsevierStyleBold">Conventional TDi Findings</span> mean &#177; SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV Sm TDi Systolic V <span class="elsevierStyleBold"><span class="elsevierStyleItalic">&#40;cm&#47;sn&#41;</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">12&#46;3&#177;2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">13&#46;1&#177;2&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV Em TDi diastolic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">10&#46;1&#177;2&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">10&#46;4&#177;2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;360&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="justify" valign="top">RV Am TD&#304; diastolic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#46;24&#177;2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#46;78&#177;&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">0&#46;880&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Tissue Doppler and Strain&#47;Strain Rate Findings&#46;</p>"
        ]
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    ]
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      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:23 [
            0 => array:3 [
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              "etiqueta" => "1"
              "referencia" => array:1 [
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                              """
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                              """
                            2 => """
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                              """
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                      ]
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                  ]
                  "host" => array:1 [
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                      "Revista" => array:7 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18036459"
                            "web" => "Medline"
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            1 => array:3 [
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                            "web" => "Medline"
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                  "contribucion" => array:1 [
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            5 => array:3 [
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                  "contribucion" => array:1 [
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                      "titulo" => "Right Ventricular Strain and Strain Rate Properties in Patients with Right Ventricular Myocardial Infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
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            6 => array:3 [
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Article information

ISSN: 18075932
Original language: English

DOI:10.6061/clinics/2013(09)09

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Year/Month	Html	Pdf	Total

2024 November	4	0	4
2024 October	36	28	64
2024 September	37	25	62
2024 August	59	35	94
2024 July	39	20	59
2024 June	69	19	88
2024 May	55	14	69
2024 April	32	19	51
2024 March	51	15	66
2024 February	34	24	58
2024 January	35	10	45
2023 December	28	23	51
2023 November	28	25	53
2023 October	29	33	62
2023 September	14	24	38
2023 August	21	11	32
2023 July	32	22	54
2023 June	35	13	48
2023 May	39	9	48
2023 April	18	1	19
2023 March	15	3	18
2023 February	12	0	12
2023 January	5	1	6
2022 December	19	5	24

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