Background : Altough MCE reliably predicts recovery of LV function, the relationship between post MI perfusion and the likelihood of LVR has not been studied. Determine the utility of myocardial contrast echocardiography(MCE) in predicting left ventricular remodeling in patients with acute anterior wall myocardial infarction. Methods : The study population consisted of 20 consecutive patients(mean age 60 years) with acute anterior myocardial infarction. who did not have specific ST segment changes at right precordial leads. RV Tei index was measured by two dimensional echocardiography and RV ejection fraction(EF) was measured by multigated blood pool(MUGA) scan. We defined subclinical RV dysfuntion as estimated RVEF was £ 40% by MUGA scan. Results : In all patients, two dimensional echocardiography showed no significant evidence of RV regional wall motion abnormality. In patients with decreased RVEF(n =10) by RV MUGA scan significantly increased RV Tei index compared with those with normal RVEF(>40%) group(n=12) (0.61짹0.12 vs 0.35짹0.14, P = 0.01). In patients with decreased RVEF group right atrial(RA) pressure by cardiac catheterization significantly increased compare with normal RVEF group(7짹2mmHg vs 10짹3mmHg, p<0.05). Conclusion : RV Tei index is simple and useful non-invasive method for diagnosis of subclinical RV dysfunction associated with inferior wall acute myocardial infarction who did not have typical ECG changes at right precordial leads.