Short-term prognostic value of TAPSE, RVFAC and Tricuspid S’ wave peak systolic velocity after first acute myocardial infarction

Abstract

Objectives: Right ventricular dysfunction impacts the prognosis of various heart diseases. We set-out to examine which right ventricular functional parameters after STEMI and NSTEMI have prognostic value. Of 297 eligible participants, 266 (149 STEMI and 117 NSTEMI) completed follow-up. All patients underwent Grace score and 2D-echocardiography within 24 h. Outcome was defined as occurrence of Major Adverse Cardiovascular events (MACE), such as death, recurrent ischaemia, arrhythmia, reinfarction, stroke or heart failure, within 30 days. Patients were categorized into patients with MACE and patients without MACE. Results:In STEMI-patients, compared to those without MACE, patients with MACE experienced higher grace score, left ventricle (LV) end-systolic volume, LV end-systolic dimension and wall motion score index values, but lower tricuspid annular plane systolic excursion, right ventricle (RV) fractional area change, Tricuspid S' wave peak systolic velocity and LV ejection fraction. Nevertheless, in NSTEMI-patients, those with MACE exhibited higher left atrial volume index values, but lower tricuspid annular plane systolic excursion, RV fractional area change, S' wave peak systolic velocity and LVEF. Right ventricular fractional area change < 37.5%, tricuspid annular plane systolic excursion < 15.8 mm and Tricuspid S' peak systolic velocity < 9.67 cm/s are independent predictors of MACE within first 30 days after STEMI and NSTEMI.

Prognostic significance of right ventricular dysfunction in patients presenting with acute left-sided heart failure

“…The primary endpoints were major adverse cardiac events: death, hospitalization for recurrent ischemia, reinfarction, HHF, arrhythmias needing hospitalization, and ischemic stroke. The follow-up period was only 30 days, and the mean LVEF was higher than in our study [ 24 ].…”

“…Similarly, Ashcroft et al [ 23 ] study on 418 AHF patients showed that the parameters of RV function, including TAPSE and RV FAC, were predictors of poor outcomes, namely all-cause mortality, which was the primary endpoint after a two-year-follow-up period. Awad et al [ 24 ] demonstrated that RV function assessment by FAC, TAPSE, or RV S' also predicted poor outcomes. However, they included a different cohort of patients presenting with acute myocardial infarction (AMI) only.…”

Elevated serum FGF21 predicts the major adverse cardiovascular events in STEMI patients after emergency percutaneous coronary intervention

“…Moreover, early echocardiography was used to assess the prognosis of STEMI patients who underwent emergency PCI. Although early echocardiography is not the best method to predict outcomes, some studies show that early echocardiography has a predictive value for the prognosis of AMI (Awad et al, 2020;Cetin et al, 2021;Reindl et al, 2019). However, a better approach would be to perform an echocardiography at the follow-up visit with a before-and-after comparison.…”

The Prognostic Importance of Right Ventricular Longitudinal Strain in Patients with Cardiomyopathies, Connective Tissue Diseases, Coronary Artery Disease, and Congenital Heart Diseases

“…The recent study showed that TAPSE, FAC, and s' were independent predictors of MACE in both STEMI and NSTEMI patients in the first 30 days after myocardial infarction [66]. The threshold values used for TAPSE, FAC, and s' were 15.8 mm; 37.5%, and 9.67 cm/s, respectively [66]. Huttin et al reported significant improvement in almost all parameters of RV systolic function (TAPSE, FAC, and RVLS) 6 months after acute myocardial infarction (AMI) [65].…”

“…The available data about RV involvement in patients with coronary artery disease are limited in comparison with information that we have about the LV role. The recent study showed that TAPSE, FAC, and s' were independent predictors of MACE in both STEMI and NSTEMI patients in the first 30 days after myocardial infarction [66]. The threshold values used for TAPSE, FAC, and s' were 15.8 mm; 37.5%, and 9.67 cm/s, respectively [66].…”