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Right ventricular dysfunction: an independent and incremental predictor of cardiac deaths late after acute myocardial infarction

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Abstract

Prognostic implication of right ventricular dysfunction and infarction scar in the chronic phase of the myocardial infarction has been little analyzed. In 299 consecutive patients (age 63 ± 11 years) with >3 months old myocardial infarction, we quantified right and left ventricular volumes and ejection fractions by cine cardiac magnetic resonance, and right and left ventricular scar tissue by late gadolinium enhancement. During follow-up (median, 2.4 years) cardiac events (cardiac-related deaths or appropriate intra-cardiac defibrillator shocks) occurred in 21 patients. Right ventricular systolic dysfunction (ejection fraction lower the reference mean values—2 SD) was present in 67 patients (22 %), right ventricular late gadolinium enhancement was observed in 15 patients (5 %). After adjustment for left ventricular end-diastolic volume, wall motion score index, and global extent of late gadolinium enhancement, right ventricular dysfunction was an independent and incremental predictor of cardiac events (p = 0.0053), while right ventricular scar tissue extent was not. Right ventricular dysfunction is an independent and incremental predictor of cardiac events also in the chronic phase of the myocardial infarction. In these patients, right ventricular dysfunction does not necessarily mean right ventricular infarction scar, but likely reflects the effects of hemodynamic and biohumoral factors.

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Acknowledgments

We are grateful to Claudia Santarlasci for her administrative support.

Conflict of Interest

None declared.

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Authors and Affiliations

  1. Institute of Clinical Physiology, CNR, Via Moruzzi, 1, 56124, Pisa, Italy

    Gianluca Di Bella, Valeria Siciliano, Daniele Rovai, Sabrina Molinaro & Alessandro Pingitore

  2. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Gianluca Di Bella & Scipione Carerj

  3. Fondazione Toscana G. Monasterio, Pisa, Italy

    Giovanni D. Aquaro, Daniele De Marchi & Massimo Lombardi

Authors
  1. Gianluca Di Bella
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  2. Valeria Siciliano
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  3. Giovanni D. Aquaro
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  4. Daniele De Marchi
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  5. Daniele Rovai
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  6. Scipione Carerj
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  7. Sabrina Molinaro
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  8. Massimo Lombardi
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  9. Alessandro Pingitore
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Correspondence to Alessandro Pingitore.

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Di Bella, G., Siciliano, V., Aquaro, G.D. et al. Right ventricular dysfunction: an independent and incremental predictor of cardiac deaths late after acute myocardial infarction. Int J Cardiovasc Imaging 31, 379–387 (2015). https://doi.org/10.1007/s10554-014-0559-9

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  • DOI: https://doi.org/10.1007/s10554-014-0559-9

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