Correlates of Impaired Global Right Ventricular Function in Patients with a Reperfused Acute Myocardial Infarction and without Right Ventricular Infarction

Hsu, Shun‐Yi; Chang, Shang‐Hung; Liu, Chih-Jen; Lin, Jeng-Feng; Ko, Yu‐Lin; Cheng, Shih‐Tsung; Chou, Hsin-Hua; Chang, Heng-Chia

doi:10.2310/jim.0b013e3182857edf

Cited by 10 publications

(18 citation statements)

References 34 publications

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“…The superiority of RVFAC over most other classical echocardiographic parameters could be due to its ability to take into account both longitudinal and radial shortening [15]. Local longitudinal parameters such as TAPSE and S 0 velocity failed to show any significant differences related to the location of MI at the acute phase in our patients with relatively preserved RV function [16]. This is in accordance with other studies reporting a poor diagnostic power of conventional parameters for initial RV extension of MI [17].…”

Section: Screening Of Rv Dysfunction After Stemisupporting

confidence: 89%

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Huttin

Lemarié

Meglio

et al. 2015

Int J Cardiovasc Imaging

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To assess the pattern of right ventricular (RV) functional recovery in a cohort of patients with successful reperfusion of a first episode of acute myocardial infarction (AMI) with 2D speckle-tracking echocardiography and cardiac magnetic resonance imaging (CMR). Ninety-five revascularized AMI patients were prospectively included (56.8 ± 11.1 years, 48 inferior, 47 anterior). RV function was assessed by echocardiography and CMR within the initial 72 h and 6 months later. A RV global strain was calculated while averaging strain values from septal, lateral and inferior walls. At the acute phase, RVEFCMR was lower in inferior than in anterior AMI patients (52.5 ± 6.8 vs. 56.0 ± 4.8, p = 0.006). Similarly, RV global, inferior and lateral strains were lower in inferior MI patients (p < 0.001 for all) whereas septal strain was not significantly different across groups. At 6 months, RVEFCMR and all strain parameters improved compared to baseline. Improvements were more substantial for patients with inferior than with anterior MI. RV parameters ultimately reached similar levels in the two groups at 6 months except for inferior strain which remained lower in patients with inferior MI (-24.5 ± 6.5 vs. -27.5 ± 5.4, p = 0.03). In low risk patients after AMI, RV function ultimately recovered over the 6 months of follow up. Higher levels of both initial impairment and subsequent recovery were observed for inferior MI. Although RV function was relatively preserved in these patients, RV strain analysis revealed a persistent impairment of RV inferior strain in patients with inferior MI, which may not be identified by RVEFCMR or conventional echocardiographic parameters.

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Section: Screening Of Rv Dysfunction After Stemisupporting

confidence: 89%

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Huttin

Lemarié

Meglio

et al. 2015

Int J Cardiovasc Imaging

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“…The lower incidence of RV involvement in the studies by Hsu et al [4] and Karakurt and Akdemir [12] than in our study could be explained by higher risk profile of our patients such as diabetes mellitus (DM; 87.5%) in our study, 28.5% in Hsu et al study [4], and 25.9% in Karakurt and Akdemir study [12], which may affect the microvascular integrity leading to higher incidence of RV involvement.…”

Section: Discussioncontrasting

confidence: 56%

“…Hsu et al [4] studied a total of 102 consecutive patients admitted with the first episode of acute MI and found that 17% of the study population who presented with anterior STEMI and underwent primary PCI had RV dysfunction, yet inferior wall MI was correlated with more impairment of RV function.…”

Section: Discussionmentioning

confidence: 99%

“…Echocardiography remains the most commonly used technique for RV function assessment in clinical practice because of its widespread availability. The myocardial performance index (MPI) of RV based on conventional Doppler echocardiography has been proven to be useful in the evaluation of RV function and recommended as one of the initial quantitative measurements of RV diastolic function and may be a sensitive tool for detecting “occult” RV dysfunction in acute LV MI [4].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of right ventricular function after successful revascularization for acute anterior myocardial infarction without right ventricular infarction by echocardiography

Abdeltawab

El-Mahmoudy

Elnammas

et al. 2019

Journal of the Saudi Heart Association

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Background Right ventricular (RV) involvement in acute left ventricular (LV) myocardial infarction (MI) is frequently underestimated in the clinical setting owing to the diagnostic limitations of the electrocardiogram and echocardiography. Objective To assess RV function in patients presented with first acute anterior ST elevation myocardial infarction (STEMI) who underwent successful primary percutaneous coronary intervention (PCI) and factors affecting it. Methods Forty consecutive patients with anterior STEMI who underwent successful primary PCI were enrolled in the study. Presence of a coexisting clinical condition that might affect RV function, patients with RV infarction or those having significant stenosis (>50%) affecting RV branch or right coronary artery proximal to RV branch were excluded. Echocardiography was performed during the hospital stay to assess the LV and RV systolic and diastolic function with special focus on tricuspid annular plane systolic excursion, RV end-diastolic dimension, right atrial area, RV fractional area change, and tissue Doppler-derived myocardial performance index. Results and Conclusion RV dysfunction according to our definition in the first anterior MI occurred in (55%) of the study population. Independent predictors for abnormal RV function were left circumflex artery mid or proximal affection, eventful procedure, occurrence of no reflow, glucose level, LV end-systolic dimension, LV end-diastolic dimension, and LV ejection fraction.

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“…The equipment used was a Philip SONOS 7500 (Agilent Technologies, Andover, MA) system. All measurements were performed and repeated by the same experienced echocardiologist 16 , 17 . The LV end-diastolic volume index (LVEDVI) was measured according to the recommendations of the American Society of Echocardiography 18 .…”

Section: Methodsmentioning

confidence: 99%

QT interval Independently Predicts Mortality and Heart Failure in Patients with ST-Elevation Myocardial Infarction

Lin¹,

Hsu²,

Wu³

et al. 2015

Int. J. Med. Sci.

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Objectives: Heart-rate corrected QT (QTc) interval predicts cardiovascular mortality or all-cause mortality in the general population. Little is known about the best cut-off value of QTc interval for predicting clinical events in patients with ST-elevation myocardial infarction (STEMI).Methods: We enrolled 264 patients with STEMI who received measurement of QTc intervals at ER (QTc-ER), on day 2 (QTc-D2), and on day 3 (QTc-D3) of hospitalization. Clinical events, including all-cause death and readmission for heart failure, were followed for 2 years.Results: Prolonged QTc-ER, but not QTc-D2 or QTc-D3, well predicted clinical events with the best cut-off value of 445 ms. Patient with QTc-ER > 445 ms had lower left ventricular ejection fraction at baseline and at 6 months. Kaplan-Meier survival curves showed that the combination of QTc-ER > 445 ms and N-terminal pro-brain natriuretic peptide (NT-pro BNP) > 936 pg/mL was a strong predictor of clinical events (p<0.001). In multivariable Cox regression analysis, the independent predictors of death and heart failure were QTc-ER (p<0.001), log NT-proBNP (p<0.001), diabetes mellitus (p<0.001), history of stroke (p=0.001), and left ventricular end diastolic volume index (p<0.001).Conclusion: QTc-ER > 445 ms independently predicts clinical events in STEMI, providing incremental prognostic value to established clinical predictors and NT-proBNP.

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Correlates of Impaired Global Right Ventricular Function in Patients with a Reperfused Acute Myocardial Infarction and without Right Ventricular Infarction

Cited by 10 publications

References 34 publications

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Assessment of right ventricular function after successful revascularization for acute anterior myocardial infarction without right ventricular infarction by echocardiography

QT interval Independently Predicts Mortality and Heart Failure in Patients with ST-Elevation Myocardial Infarction

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