Impact of right ventricular diastolic dysfunction on clinical outcomes in inferior STEMI

Altıntaş, Bernas; Yaylak, Barış; Ede, Hüseyin; Altındağ, Rojhat; Baysal, Erkan; Bilge, Önder; Çiftçi, Hacı; Adıyaman, Mehmet Şahin; Karahan, Mehmet; Kaya, İlyas; Çevik, Kemal

doi:10.1007/s00059-017-4631-9

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…These results can be explained by a report from the SHOCK registry published in 2003, which stated that RVMI does not influence in-hospital mortality rates on patients in cardiogenic shock [13]. Moreover, recent studies have shown that in-hospital mortality after inferior myocardial infarction with RVMI depends on the presence of restrictive right ventricular filling [14]. In our study, we did not evaluate the echocardiographic findings, this remains a subject of interest for a further studies.…”

Section: In-hospital Mortalitymentioning

confidence: 70%

Retrospective analysis of complications and survival in patients with acute inferior myocardial infarction accompanied by right ventricular myocardial infarction

Neverauskaite-Piliponiene

Kūgienė

Petrulionienė

et al. 2019

Seminars in Cardiovascular Medicine

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Summary Right ventricular myocardial infarction (RVMI) accompanies about 30–50% of inferior wall myocardial infarction. RVMI is associated with higher rates of cardiogenic shock, atrioventricular block, atrial fibrillation, increased mortality rates. The topic requires a scientific update, as only a few studies have been made on RVMI during the past decade. We aimed to analyse the impact of RVMI on inferior myocardial infarction. Design and methods: Retrospective study included 310 patients with documented inferior myocardial infarction (with and without RVMI) between January 2013 and January 2014. Data on baseline characteristics, mortality, in-hospital complications: cardiogenic shock and rhythm and conduction disorders was collected. Results: In 102 (32.9%) patients with inferior myocardial infarction, RVMI was present and 208 (67.1%) cases were without RVMI involvement. RVMI patients had higher rate of rhythm and conduction disturbances than patients without RVMI involvement: atrioventricular block (OR 3.8, 95% CI 2.0–7.1, p < 0.001), atrial fibrillation (OR 1.6, 95% CI 0.9–2.9, p = 0.001), also higher incidence of cardiogenic shock (OR 2.6, 95% CI 1.7–3.9, p < 0.001). Mortality rates after 24 months were higher in RVMI group (OR 1.8, 95% CI 1.2–3.8, p = 0.034). No significant difference was found on in-hospital mortality. Conclusions: Right ventricular involvement complicates the long-term mortality and outcomes after inferior myocardial infarction. It is related to a higher incidence of in-hospital complications, especially I–III degree AV block and atrial fibrillation. However, influence on long-term mortality needs further investigation.

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Section: In-hospital Mortalitymentioning

confidence: 70%

Retrospective analysis of complications and survival in patients with acute inferior myocardial infarction accompanied by right ventricular myocardial infarction

Neverauskaite-Piliponiene

Kūgienė

Petrulionienė

et al. 2019

Seminars in Cardiovascular Medicine

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“…MACE developed in 5 patients of which 4 patients complicated during hospital stay. B Altıntaş also reported that all the MACE in his study developed during the hospital stay [ 18 ]…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of right ventricular diastolic dysfunction in patients with inferior ST-elevated myocardial infarction

et al. 2023

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Background Right ventricle infarction (RVI) is predominantly a complication of inferior wall myocardial infarction; it occurs in approximately one third of these patients. Right ventricular dysfunction in patients with inferior STEMI and RV infarction was under assessed. Nevertheless, studies which targeted RV assessment by echocardiography, did not routinely evaluate RV diastolic dysfunction. In this study, we aimed to evaluate RV diastolic dysfunction and its prognostic value in patients with inferior STEMI and RVI. Results Sixty patients with inferior STEMI and RV infarction, who underwent primary PCI were enrolled in the study. Patients with pre-existing clinical conditions that might affect RV function, were excluded. Echocardiography was performed within twenty-four hours following the PCI, to assess the RV systolic and diastolic functions with special focus on tricuspid inflow velocities (E velocity, A velocity and E/A ratio) by pulsed wave (PW) doppler and tricuspid annular velocities by tissue doppler index (TDI) (E′, A′ and E/E′ ratio). Clinical features and MACE, including cardiogenic shock, arrhythmia, stroke, reinfarction and death were analyzed in all our patients within 3 months follow up period. The average age of the study population was 51.58 ± 10.11 years, 10% were females. Five patients developed MACE (death, cardiogenic shock and pulmonary edema, anterior STEMI and cardiogenic shock, recurrent inferior STEMI, and arrhythmia and stroke), of whom four occurred in hospital within the first 48 h. Patients who developed MACE had high filling pressures, as all of them had E/E′ > 6. E′ velocity ≤ 6 cm/sec was associated with increased MACE as 25% of patients with E′ velocity ≤ 6 had MACE compared with 2.3% of patients with E′ velocity > 6 with a p value of 0.015. Conclusions Tricuspid annular velocities by TDI are essential when evaluating RV diastolic dysfunction. E/E′ and E′ velocity have a prognostic value in patients with inferior STEMI and RV infarction; E/E′ > 6 and E′ velocity ≤ 6 cm/sec were associated more MACE in patients with inferior STEMI and RVI.

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“…In addition to the usual history and physical examination, myocardial ischemia may also be associated with abnormalities in the electrocardiogram (ECG) and increased biochemical markers like cardiac troponins 4 . Inferior infarcts are to blame for poor results 5 . Reduced blood flow to the atrioventricular node (AV) due to an inferior MI can result in complete atrioventricular block (CAVB).…”

Section: Introductionmentioning

confidence: 99%

“…Reduced blood flow to the atrioventricular node (AV) due to an inferior MI can result in complete atrioventricular block (CAVB). This condition is often short-lived, lasting for little more than two weeks 5 . Hemi-blocks may come before CAVB 6 .…”

Section: Introductionmentioning

confidence: 99%

Outcome of Primary Percutaneous Coronary Intervention Among Patients of Complete Atrioventricular Block with Acute Inferior St-Elevation Myocardial Infarction

Rashid¹,

Butt²,

Khan³

et al. 2022

PJMHS

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Aim: To assess the outcomes of primary percutaneous coronary intervention among patients of complete atrioventricular block with acute inferior ST-elevation myocardial infarction Methods: We conducted an observational study of patients with CAVB and STEMI who underwent Primary PCI at interventional cardiology department, national institute of cardiovascular diseases Karachi during the period from January 1, 2022 to July 31, 2022. The primary outcomes were in-hospital mortality and CAVB resolution. Results: A total of 100 patients were included in the study. The mean age was 60.63±5.63 years, and 61% were male. The median door-to-balloon time was 89.96±17.97 minutes. In hospital mortality rate was 4%. CAVB was resolved in 93%. Conclusion: For patients with CAVB and STEMI, Primary PCI is a safe and successful treatment with a low rate of in-hospital mortality. These findings support the use of primary PCI in this patient population. Keyword: Primary PCI, CAVB, STEMI

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Impact of right ventricular diastolic dysfunction on clinical outcomes in inferior STEMI

Abstract: Presence of RRVFP is associated with in-hospital mortality in patients presenting with their first IWMI complicated by RVMI.

Cited by 7 publications

References 31 publications

Retrospective analysis of complications and survival in patients with acute inferior myocardial infarction accompanied by right ventricular myocardial infarction

Retrospective analysis of complications and survival in patients with acute inferior myocardial infarction accompanied by right ventricular myocardial infarction

Prognostic value of right ventricular diastolic dysfunction in patients with inferior ST-elevated myocardial infarction

Outcome of Primary Percutaneous Coronary Intervention Among Patients of Complete Atrioventricular Block with Acute Inferior St-Elevation Myocardial Infarction

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