Association of the right ventricle impairment with electrocardiographic localization and related artery in patients with ST-elevation myocardial infarction

Kaňovský, Jan; Kala, Petr; Novotný, Tomáš; Benešová, Klára; Holická, Mária; Jarkovský, Jiří; Koc, Lumír; Mikolášková, Monika; Ondrúš, Tomáš; Malik, Marek

doi:10.1016/j.jelectrocard.2016.08.001

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…This can be explained by the MRI study conducted by Bonanad et al who reported that microvascular obstruction frequently occurs in the RV in patients with anterior STEMI 15 . In addition, significant myocardial apoptosis 16 and myocardial edema 17 in the RV may be documented in these patients. However, it is unclear whether RV dysfunction after anterior AMI also portends poor prognosis or not 18 .…”

Section: Discussionmentioning

confidence: 98%

Short‐ and long‐term prognostic value of right ventricular function in patients with first acute ST elevation myocardial infarction treated by primary angioplasty

2021

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Introduction Limited data are known about the prognostic value of right ventricle (RV) function in patients with first acute ST‐segment elevation myocardial infarction (STEMI). The aim of this study was to investigate the prognostic value of RV dysfunction in predicting both in‐hospital and long‐term outcomes in these patients, irrespective of the site of necrosis. Methods We enrolled 502 consecutive patients with first acute STEMI treated with primary angioplasty and underwent echocardiography within 48 hours of admission. RV function was evaluated by RV myocardial performance index (RVMPI), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), pulsed tissue Doppler S′ wave velocity, and RV global longitudinal strain (RVGLS) of the free wall. The occurrence of in‐hospital major adverse cardiac events (MACE) and 1‐year survival rate were recorded. Results In MACE group, RVFAC, TAPSE, and RV S′ wave velocity were lower. However, RVMPI, RVGLS, and TR Vmax. were higher than MACE free group (P < .001). In multivariable analysis adjusted for other variables that predicted adverse outcomes, RVFAC < 35% (P < .001), TAPSE < 17 mm (P < .001), RVGLS > −17% (P < .001), RV S′ wave velocity < 9.5 cm/s (P = .02), RVMPI > 0.43 (P < .001), and TR Vmax. > 2.8 m/s (P = .01) were strong independent predictors of in‐hospital MACE. Lower 1‐year survival was noted in patients with RV dysfunction, documented by these cutoffs values. Conclusion RV dysfunction, evidenced by multiparametric echocardiography, is predictive for adverse in‐hospital outcomes, and lower 1‐year survival rate in first acute STEMI regardless of the site of necrosis.

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Section: Discussionmentioning

confidence: 98%

Short‐ and long‐term prognostic value of right ventricular function in patients with first acute ST elevation myocardial infarction treated by primary angioplasty

2021

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“…To our knowledge, two potential reasons may explain our current findings. First, RVMI may compromise left ventricular cardiac output due to decreased RV contraction and increased mPAP 21,22 . Indeed, in our current study, we also observed that compared to those without RVMI, patients with RVMI had lower right ventricular ejection fraction and higher mPAP, and all these hemodynamic changes in turn could impair left ventricular function and cardiac output.…”

Section: Discussionmentioning

confidence: 99%

Impact of concurrent right ventricular myocardial infarction on outcomes among patients with left ventricular myocardial infarction

Liao

Chen

Liu

et al. 2020

Sci Rep

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to compare in-hospital outcomes between left ventricular myocardial infarction (LVMi) patients with and without right ventricular myocardial infarction (RVMi). patients with acute St-segment elevation Mi (SteMi) undergoing primary percutaneous coronary intervention (pci) were enrolled and divided into LVMI with and without RVMI groups. Between-group differences and in-hospital outcomes were compared. compared to patients without RVMi, patients with RVMi were more likely to be male, have higher body mass index, serum levels of C-reactive protein (8.9 ± 2.4 vs 6.2 ± 2.1 mg/dL), B-type natriuretic peptide (1295 ± 340 vs 872 ± 166 pg/mL) and cardiac troponin-I (8.6 ± 2.9 vs 5.2 ± 2.1 ng/ mL), and have diabetes (36.3% vs 3.4%) and dyslipidemia (53.4% vs 48.1%). Patients with RVMI had lower left and right ventricular ejection fraction (50.5 ± 5.6% vs 53.4 ± 3.8% and 33.6 ± 2.9% vs 45.7 ± 2.0%), but had higher mean pulmonary artery pressure (30.6 ± 3.3 vs 23.8 ± 3.1 mm Hg). compared to patients without RVMi, patients with RVMi had higher odds of in-hospital allcause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). After adjusted for confounding factors, LVMi with RVMi remained independently associated with composite outcomes, with odds ratio 1.66 (95% confidence interval 1.39-2.04). Compared to isolated LVMI patients, those with concomitant RVMi have higher odds of in-hospital complications, particularly all-cause mortality and new onset acute heart failure.

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“…Interestingly, Kanovsky el al. [ 8 ] reported in a survey of 300 patients with electrocardiographic defined RVMI (V4R ST segment elevation) that the culprit vessel was the right coronary artery in only 48% of the cases, the left anterior descending artery in 47%, and the circumflex artery in 5% of cases. One should also note that in this study RV function was not evaluated and we could only infer it to be worse in patients with RCA occlusion because of the greater magnitude of RV branches from this vessel.…”

Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction Caused by an Anomalous Right Coronary Artery Occlusion Presenting with Precordial ST Elevation

Matte¹,

Azmus²

2017

Case Reports in Cardiology

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Acute coronary syndrome with precordial ST segment elevation is usually related to left anterior descending artery occlusion, although isolated right ventricular infarction has been described as a cause of ST elevation in V1–V3 leads. We present a case of a patient with previous inferior wall infarction and new acute ST elevation myocardial infarction (STEMI) due to proximal right coronary thrombotic occlusion resulting in right ventricular infarction with precordial ST elevation and sinus node dysfunction. The patient was treated with successful rescue angioplasty achieving resolution of acute symptoms and electrocardiographic abnormalities.

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Association of the right ventricle impairment with electrocardiographic localization and related artery in patients with ST-elevation myocardial infarction

Cited by 10 publications

References 12 publications

Short‐ and long‐term prognostic value of right ventricular function in patients with first acute ST elevation myocardial infarction treated by primary angioplasty

Short‐ and long‐term prognostic value of right ventricular function in patients with first acute ST elevation myocardial infarction treated by primary angioplasty

Impact of concurrent right ventricular myocardial infarction on outcomes among patients with left ventricular myocardial infarction

Acute Myocardial Infarction Caused by an Anomalous Right Coronary Artery Occlusion Presenting with Precordial ST Elevation

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