Rapid hemodynamic improvement after reperfusion during right ventricular infarction

Kinn, James W.; Ajluni, Steven C.; Samyn, Joseph G.; Bates, Eric R.; Grines, Cindy L.; O’Neill, William W.

doi:10.1016/0735-1097(95)00311-8

Cited by 52 publications

(25 citation statements)

References 11 publications

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“…5,8,11,12 Of 165 patients screened, 40 were excluded because of technically inadequate echocardiographic images, leaving 125 patients analyzed in this study who underwent emergency coronary angiography according to standard techniques. 8,[13][14][15] …”

Section: Methodsmentioning

confidence: 99%

Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction

et al. 2002

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Background-Although proximal right coronary artery (RCA) occlusion is the culprit commonly responsible for acute right ventricular (RV) infarction (RVI), the severity of RV dysfunction ranges broadly. This study was designed to delineate the patterns of coronary compromise that determine the magnitude of RV ischemic dysfunction. Methods and Results-In 125 patients with acute inferior myocardial infarction undergoing emergency angiography, the culprit infarct lesion was identified, RV branch flow assessed (TIMI flows and frame counts), and individual patient RV perfusion indices calculated by separately averaging the branch flows and frame counts, which were correlated with RV wall motion by ultrasound. RVI occurred in 53 (42%) patients, with the RCA as the culprit vessel and the lesion sufficiently proximal to compromise flow in at least one RV branch in all cases, thereby resulting in depressed RV perfusion (flow index, 0.7Ϯ0.2). In patients without RVI, the RCA was the culprit in 89%; the circumflex, in 11%. RCA culprits were proximal in 19% of such cases, with lack of RVI explained by preserved RV perfusion (flow index, 2.7Ϯ0.3; Pϭ0.001) attributable to at least 1 patent RV branch, spontaneous reperfusion, or prominent collaterals.Overall, there was a strong correlation between RV perfusion and wall motion (Spearman correlation coefficientϭ0.79). Conclusions-Proximal RCA occlusion compromising RV branch perfusion commonly results in RV ischemic dysfunction. In some cases with proximal RCA culprits, collaterals or spontaneous reperfusion preserve RV performance.

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Section: Methodsmentioning

confidence: 99%

Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction

et al. 2002

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“…Therefore, without a doubt reperfusion therapy should be applied by any method in this high-risk entity. [27][28][29] …”

Section: Discussionmentioning

confidence: 99%

The impact of right atrial ischemia on inferior myocardial infarction with extension to right ventricle: Transesophageal echocardiographic examination

Vargas-Barrón

López–Meneses

Roldán

et al. 2002

Clinical Cardiology

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SummaryBackground: The role of the right atrium in adaptation to the hemodynamic changes produced by extension of myocardial infarction (MI) of the left ventricular inferior wall to the right ventricle is fundamental.Hypothesis: The aim of this study was analyze a group of patients with MI with extension of right chambers, and particularly right atrial alterations, by transesophageal echocardiography and to correlate it with clinical and angiographic variables.Methods: Thirty patients with right ventricular (RV) MI involving obstruction of the right coronary artery without stenosis of the left coronary artery were included; 18 underwent early reperfusion. Transesophageal echocardiography was performed on all within 5 days of coronary angiography. Follow-up was continued from hospitalization to the present.Results: When patients with right atrial ischemia were compared with those with normal right atrium, the RV wall movement score was significantly greater in the group with right atrial ischemia, severe RV dilatation was more frequent, and association with proximal occlusion of the artery responsible for the MI, as well as absence of right atrial branches and poor collateral circulation, were significant. Hospitalization was

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“…These findings were similar to the studies of Roth A et al [10] and Tabone X et al [11] which suggested thrombolytic therapy was of little benefit in improving RV function early after MI. In another study by Kinn et al, [12] there was rapid improvement in haemodynamics only in patients with successful reperfusion of the infarct related artery after thrombolytic therapy. Probably failed reperfusion or early stunning of RV might have contributed to these findings in our study.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Right Ventricular Function in Acute St-Elevation Myocardial Infarction by Echocardiography

Krishna¹

2017

jemds

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BACKGROUNDRight Ventricular (RV) function has been shown to be a major determinant of clinical outcome and consequently should be considered during clinical management and treatment. Thus, the need for diagnosis of RV dysfunction is evident. MATERIALS AND METHODS RESULTSIncidence of RV dysfunction in study population by TAPSE<1.5 cm was 44 (22%). 23 (29.1%) patients with Inferior wall MI had RV dysfunction and 21 (17.3%) patients with anterior wall MI had RV dysfunction. Out of 200 patients with acute myocardial infarction, 22% (44/200) had RV dysfunction. Mean age of patients in RV dysfunction group was 57.4 ± 11.3 years and of patients in no-RV dysfunction (Normal RV function) group was 52.3 ± 11.2 years (p =0.008). 15.9% (7/44) patients in RV dysfunction group had past history of Coronary artery disease compared to 5.8% (9/156) in normal RV function group (p=0.02). CONCLUSIONNearly one fourth of patients with Acute ST-Elevation Myocardial Infarction had right ventricular dysfunction. LV dysfunction contributes significantly to RV dysfunction in acute myocardial infarction more so in anterior wall MI. KEYWORDS BACKGROUNDRight Ventricular (RV) function may be impaired either by primary right-sided heart disease, or secondary to left-sided cardiomyopathy or valvular heart disease. In addition, it should be considered that RV dysfunction may affect left ventricular (LV) function, not only by limiting LV preload, but also by adverse systolic and diastolic interaction via the interventricular septum and the pericardium (ventricular interdependence). Moreover, RV function has been shown to be a major determinant of clinical outcome and consequently should be considered during clinical management and treatment. Thus, the need for diagnosis of RV dysfunction is evident.

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Rapid hemodynamic improvement after reperfusion during right ventricular infarction

Abstract: Reperfusion in the setting of right ventricular infarction leads to rapid hemodynamic improvement and may result in improved survival.

Cited by 52 publications

References 11 publications

Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction

Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction

The impact of right atrial ischemia on inferior myocardial infarction with extension to right ventricle: Transesophageal echocardiographic examination

Assessment of Right Ventricular Function in Acute St-Elevation Myocardial Infarction by Echocardiography

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