Right ventricular longitudinal strain predicts acute kidney injury and short-term prognosis in patients with right ventricular myocardial infarction

Ivey‐Miranda, Juan Betuel; Almeida-Gutiérrez, Eduardo; Borrayo–Sánchez, Gabriela; Antezana-Castro, Javier; Contreras-Rodríguez, Alicia; Posada-Martínez, Edith Liliana; Gonzalez-Morales, E.; Garcia-Hernandez, N; Romero-Zertuche, Diana; Márquez-González, Horacio; Saturno-Chiu, Guillermo

doi:10.1007/s10554-018-1447-5

Cited by 11 publications

(5 citation statements)

References 33 publications

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“…In the current study, we found that lower RV strain was associated with increased MACCEs and improved the accuracy of risk stratification only based on the impairment of LV strain. Besides, our finding that reduction of RV strain could be found in all-location infarctions may be an important supplement to previous studies that had only researched RV strain in patients with RV or inferior infarctions (23,24). The mechanism of RV strain impairments in non-inferior infarctions might be similar to right heart dysfunction due to left heart failure (25).…”

Section: Discussionsupporting

confidence: 72%

Impact of Concomitant Impairments of the Left and Right Ventricular Myocardial Strain on the Prognoses of Patients With ST-Elevation Myocardial Infarction

Wei

Dong

et al. 2021

Front. Cardiovasc. Med.

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Background: The impact of concomitant impairments of left and right ventricular (LV and RV) strain on the long-term prognosis of acute ST-elevation myocardial infarction (STEMI) is not clear.Methods: We analyzed CMR images and followed up 420 first STEMI patients from the EARLY Assessment of MYOcardial Tissue Characteristics by CMR in STEMI (EARLY-MYO-CMR) registry (NCT03768453). These patients received timely primary percutaneous coronary intervention (PCI) within 12 h and CMR examination within 1 week (median, 5 days; range, 2–7 days) after infarction. Global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of both ventricles were measured based on CMR cine images. Conventional CMR indexes were also assessed. Primary clinical outcome was composite major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, re-hospitalization for heart failure and stroke. In addition, CMR data from 40 people without apparent heart disease were used as control group.Results: Compared to controls, both LV and RV strains were remarkably reduced in STEMI patients. During follow-up (median: 52 months, interquartile range: 29–68 months), 80 patients experienced major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, heart failure, and stroke. LV-GCS > −11.20% was an independent predictor of MACCEs (P < 0.001). RV-GRS was the only RV strain index that could effectively predict the risk of MACCEs (AUC = 0.604, 95% CI [0.533, 0.674], P = 0.004). Patient with RV-GRS ≤ 38.79% experienced more MACCEs than those with preserved RV-GRS (log rank P < 0.001). Moreover, patients with the concomitant decrease of LV-GCS and RV-GRS were more likely to experience MACCEs than patients with decreased LV-GCS alone (log rank P = 0.010). RV-GRS was incremental to LV-GCS for the predictive power of MACCEs (continuous NRI: 0.327; 95% CI: 0.095–0.558; P = 0.006). Finally, tobacco use (P = 0.003), right coronary artery involvement (P = 0.002), and LV-GCS > −11.20% (P = 0.012) was correlated with lower RV-GRS.Conclusions: The concomitant decrease of LV and RV strain is associated with a worse long-term prognosis than impaired LV strain alone. Combination assessment of both LV and RV strain indexes could improve risk stratification of patients with STEMI.Trial Registration:ClinicalTrials.gov, NCT03768453. Registered 7 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03768453.

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Section: Discussionsupporting

confidence: 72%

Impact of Concomitant Impairments of the Left and Right Ventricular Myocardial Strain on the Prognoses of Patients With ST-Elevation Myocardial Infarction

Wei

Dong

et al. 2021

Front. Cardiovasc. Med.

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“…Therefore, the analysis of RV longitudinal strain is a measure that can accurately reflect RV systolic function as suggested by its ability to detect even mild abnormalities and to predict a worse prognosis. 22) RV strain represents morphological and functional changes in several factors, such as contractility, preload, and afterload. RV performance is also affected by the heart rhythm, synchrony of ventricular contraction, RV force interval relationship, and ventricular interdependence.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Simultaneous Analysis with Myocardial Flow Reserve and Right Ventricular Strain by Hybrid <sup>13</sup>N-Ammonia Positron Emission Tomography/Magnetic Resonance Imaging in Coronary Artery Disease

et al. 2022

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Myocardial flow reserve (MFR) derived from 13 N-ammonia positron emission tomography (PET) is used to predict adverse cardiac events in patients with coronary artery disease (CAD). Right ventricular global longitudinal strain (RVGLS) measured by magnetic resonance imaging (MRI) is used to evaluate RV function and predict cardiac events. This study aimed to evaluate the prognostic value of MFR and RVGLS measured by hybrid 13 N-ammonia PET/MRI in patients with CAD.Sixty-one patients who underwent 13 N-ammonia PET/MRI were analyzed. The end points were defined as a composite of all-cause death, myocardial infarction, sustained ventricular arrhythmia, hospitalization due to decompensated heart failure, and revascularization. At a follow-up of 2.8 ± 1.9 years, 21 events had occurred. Kaplan-Meier analysis showed that the event-free rate was significantly lower in the group with MFR < 1.80 than in that with MFR "1.80 (P < 0.001). Additionally, the event-free rate was significantly lower in the group with RVGLS > −18.22% than in that with RVGLS !−18.22% (P = 0.025). After dividing the patients into 4 groups by the median MFR and the median RVGLS, the event-free rate was lowest in the combined group of MFR < 1.80 and RVGLS > −18.22% than any other groups (P < 0.001). In a Cox proportional hazard analysis, MFR and RVGLS were independent predictors of cardiac adverse events in the patients with CAD.The simultaneous assessment of MFR and RVGLS by 13 N-ammonia PET/MRI revealed the feasibility of precise risk stratification for cardiac events in patients with CAD.

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“…The RV function has been identified as a significant predictor of HF development and mortality in patients with MI following LV insufficiency ( 2 ). RV systolic dysfunction is associated with serious complications in the short-term period aftermath of MI ( 3 ). Furthermore, RV dysfunction plays a crucial role in the development of multi-system organ failure and mortality associated with HF ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Assessing right ventricular peak strain in myocardial infarction patients with mitral regurgitation by cardiac magnetic resonance feature tracking

Wen,

Gao,

Guo

et al. 2024

Quant Imaging Med Surg

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Background Although it is known that mitral regurgitation (MR) in patients with myocardial infarction (MI) may increase the right ventricular (RV) afterload, leading to RV dysfunction, the exact detrimental effects on RV function and myocardial peak strain remain unresolved. In this study, we assessed the impact of MR on the impairment of RV myocardial deformation in patients with MI and explored the independent influential factors of RV peak strain. Methods A total of 199 MI participants without or with MR were retrospectively assessed in this study. The cardiovascular magnetic resonance examination protocol included a late gadolinium-enhanced (LGE) imaging technique and a cine-balanced steady-state free precession sequence. Statistical tests, including two independent sample t -test or Mann-Whitney U-test, analysis of variance, Kruskal-Wallis test, and multiple linear regression analysis models were performed. Results The MI (MR+) group exhibited significantly lower RV strain parameters in the radial, circumferential and longitudinal directions when compared to the control and the MI (MR−) groups (both P<0.05). The RV global longitudinal peak strain (GLPS) in the MI group significantly decreased when compared with that in the control group (P<0.05). As moderate-severe MR worsened in patients with MI, RV myocardial global peak strain and the peak systolic strain rate (PSSR) gradually decreased. Multiple linear regression analysis revealed that left ventricular (LV) GLPS, triglycerides, and age were independently correlated with RV GLPS (all P<0.05). RV end-systolic volume (RVESV) acted as an independent association factor for RV global peak strain. Conclusions MR may exacerbate the impairment of RV peak strain and functions in patients with MI. LV GLPS was positively correlated with RV GLPS. However, RVESV, triglycerides, and age acted as independent risk factors associated with worsening RV GLPS.

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Right ventricular longitudinal strain predicts acute kidney injury and short-term prognosis in patients with right ventricular myocardial infarction

Cited by 11 publications

References 33 publications

Impact of Concomitant Impairments of the Left and Right Ventricular Myocardial Strain on the Prognoses of Patients With ST-Elevation Myocardial Infarction

Impact of Concomitant Impairments of the Left and Right Ventricular Myocardial Strain on the Prognoses of Patients With ST-Elevation Myocardial Infarction

Prognostic Value of Simultaneous Analysis with Myocardial Flow Reserve and Right Ventricular Strain by Hybrid <sup>13</sup>N-Ammonia Positron Emission Tomography/Magnetic Resonance Imaging in Coronary Artery Disease

Assessing right ventricular peak strain in myocardial infarction patients with mitral regurgitation by cardiac magnetic resonance feature tracking

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