Right Atrial Volume Index as a Predictor of Persistent Right Ventricular Dysfunction in Patients with Acute Inferior Myocardial Infarction and Proximal Right Coronary Artery Occlusion Treated with Primary Percutaneous Coronary Intervention

Abstract

Objectives Patients with right ventricular (RV) infarctions associated with inferior infarctions have higher rates of adverse events than isolated inferior infarctions. Right atrial volume index (RAVI) has recently been described as a predictor of clinical outcome in patients with chronic systolic heart failure and pulmonary hypertension. The aim of this study is to assess the ability of RAVI to predict the persistent RV dysfunction after acute inferior STEMI due to occlusion of proximal RCA. To the best of our knowledge, this is the first study to investigate the relation between RAVI and persistent RV dysfunction in such group of patients. Patients and methods Sixty-five consecutive patients with recent first acute inferior STEMI who underwent primary percutaneous coronary intervention (PPCI) were prospectively included in the study. Echocardiographic evaluation was performed at the time of discharge and at 3 months. All the patients underwent standard echocardiographic assessment using conventional 2D and tissue Doppler imaging (TDI). Results Patients were divided into two groups according to right ventricular function (RVF) 3 months after acute myocardial infarction (AMI). The normal RVF group included 41 (63%) patients and the impaired RVF group included 24 (37%) patients. RAVI was significantly higher in patients with impaired RVF (p=<0.001). RAVI was a predictor of persistently impaired RV function (odds ratio = 1.786, 95% confidence interval, 1.367–2.335, p value= <0.001) and (odds ratio = 1.829, 95% confidence interval, 1.358–2.462, p value= <0.001) in univariate and multivariable logistic regression analyses respectively. In receiving operator characteristics (ROC) curve analysis, RAVI with a cutoff value ≥ 30 ml/m 2 had a 87.5% sensitivity, a 92.24% specificity area under Receiving operator characteristics (ROC) curve = 0.964 for predicting persistently impaired RVF. Conclusion In patients with inferior STEMI with proximal RCA occlusion, RAVI is an independent predictor of persistently impaired RVF with a cut-off value ≥ 30 ml/m 2 .

Application Effect and Evaluation of Two-Dimensional Speckle Tracking Imaging on Myocardial Damage in Patients with Malignant Lymphoma Treated with Anthracyclines

“…erefore, patients treated with chemoradiotherapy often take drugs to protect organs and reduce the impact of chemoradiotherapy on other organ functions. Anthracyclines are commonly used chemotherapeutic drugs in clinic, which play a significant role in the treatment and control of various visible tumors and hematological tumors, with excellent treatment results [18][19][20]. However, clinical trials have shown that anthracyclines have a great impact on myocardial function of patients, and chemotherapy with anthracyclines may cause myocardial damage in patients.…”

Echocardiographic evaluation of the right atrial size and function: Relevance for clinical practice

“…Two-dimensional (2DE) and three-dimensional (3DE) echocardiography are the most commonly employed noninvasive imaging techniques to evaluate RA size [11] , [12] , [13] . Volumetric assessment of the RA size may be more accurate than linear measurement because RA enlargement is asymmetrical.…”

Assessment of right atrial function in inferior wall AMI

“…The cutoff value of RAVI 30 mL/m 2 had a 87.5% sensitivity, a 92.24% specificity for predicting persistently impaired RV function. 9 The importance of predicting persistence RV dysfunction came from the fact that persistent RV dysfunction is associated with long term poor prognosis irrespective of LV systolic function. 10,11 Liao et al, outcomes between left ventricular myocardial infarction patients with and without RV myocardial infarction (RVMI) in 458 patients with acute (STEMI) undergoing primary percutaneous coronary intervention.…”