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The association of right ventricular dysfunction with in-hospital and 1-year outcomes in anterior myocardial infarction

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Abstract

In anterior ST-segment elevation myocardial infarction (STEMI), attention paid mainly to the left ventricle. The predictive significance of right ventricular (RV) dysfunction in patients with anterior STEMI has been frequently neglected. In this study, we evaluated the prognostic effect of RV dysfunction on in-hospital and long-term outcomes in patients with first anterior STEMI. A total of 350 patients without known coronary artery disease with first anterior STEMI and treated with primary percutaneous coronary intervention were prospectively enrolled in this study. In-hospital and long-term outcomes were compared between two groups of with or without RV dysfunction. In-hospital mortality was significantly higher in the RV dysfunction group (26.7% vs. 1.6%, P < 0.001). The RV dysfunction group also had a higher incidence of cardiogenic shock, recurrent myocardial infarction, target lesion revascularization and stent thrombosis. The 1-year overall survival in patients with and without RV dysfunction was 62.2% and 95.0% respectively. After multivariable analysis, RV dysfunction remained as an independent predictor for in-hospital and long-term mortality. RV dysfunction is an independent predictor of cardiogenic shock, recurrent myocardial infarction, and, in-hospital and long-term mortality in anterior STEMI. Therefore, attention should be paid to the function of right ventricle as in the left ventricle after anterior STEMI.

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References

  1. World Health Organization (2008) Fact sheet—the top ten causes of death. Fact sheet No 310, October. http://www.who.int/mediacentre/ factsheets/fs310_2008.pdf

  2. Widimsky P, Wijns W, Fajadet J, de Belder M, Knot J, Aaberge L et al (2010) Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Eur Heart J 31(8):943–957

    Article  PubMed  Google Scholar 

  3. Azevedo PS, Cogni AL, Farah E, Minicucci MF, Okoshi K, Matsubara BB et al (2012) Predictors of right ventricle dysfunction after anterior myocardial infarction. Can J Cardiol 28(4):438–442

    Article  PubMed  Google Scholar 

  4. Goldstein JA (2002) Pathophysiology and management of right heart ischemia. J Am Coll Cardiol 40(5):841–853

    Article  PubMed  Google Scholar 

  5. Hamon M, Agostini D, Le Page O, Riddell JW, Hamon M (2008) Prognostic impact of right ventricular involvement in patients with acute myocardial infarction: meta-analysis. Crit Care Med 36(7):2023–2033

    Article  PubMed  Google Scholar 

  6. Larose E, Ganz P, Reynolds HG, Dorbala S, Di Carli MF, Brown KA et al (2007) Right ventricular dysfunction assessed by cardiovascular magnetic resonance imaging predicts poor prognosis late after myocardial infarction. J Am Coll Cardiol 49(8):855–862

    Article  PubMed  Google Scholar 

  7. Zornoff LA, Skali H, Pfeffer MA, St John Sutton M, Rouleau JL, Lamas GA et al (2002) Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J Am Coll Cardiol 39(9):1450–1455

    Article  PubMed  Google Scholar 

  8. Pfisterer M (2003) Right ventricular involvement in myocardial infarction and cardiogenic shock. Lancet 362(9381):392–394

    Article  PubMed  Google Scholar 

  9. Bodi V, Sanchis J, Mainar L, Chorro FJ, Nunez J, Monmeneu JV et al (2010) Right ventricular involvement in anterior myocardial infarction: a translational approach. Cardiovasc Res 87(4):601–608

    Article  CAS  PubMed  Google Scholar 

  10. Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA et al (2012) ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J 33(20):2569–2619

    Article  CAS  PubMed  Google Scholar 

  11. Hsu RK, Hsu CY (2012) Acute kidney injury: comment on “trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction”. Arch Intern Med 172(3):253–254

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG et al (2007) Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care (London England) 11(2):R31

    Article  Google Scholar 

  13. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K et al (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23(7):685–713 (quiz 86–8).

    Article  Google Scholar 

  14. Mehta SR, Eikelboom JW, Natarajan MK, Diaz R, Yi C, Gibbons RJ et al (2001) Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol 37(1):37–43

    Article  CAS  PubMed  Google Scholar 

  15. Foppa M, Arora G, Gona P, Ashrafi A, Salton CJ, Yeon SB et al (2016) Right ventricular volumes and systolic function by cardiac magnetic resonance and the impact of sex, age, and obesity in a longitudinally followed cohort free of pulmonary and cardiovascular disease: the Framingham Heart Study. Circ Cardiovasc Imaging 9(3):e003810

    Article  PubMed  Google Scholar 

  16. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ (2008) Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation 117(11):1436–1448

    Article  PubMed  Google Scholar 

  17. Huttin O, Lemarié J, Di Meglio M, Girerd N, Mandry D, Moulin F et al (2015) Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography. Int J Cardiovasc Imaging 31(3):537–545

    Article  PubMed  Google Scholar 

  18. Anavekar NS, Skali H, Bourgoun M, Ghali JK, Kober L, Maggioni AP et al (2008) Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study). Am J Cardiol 101(5):607–612

    Article  PubMed  Google Scholar 

  19. Bonanad C, Ruiz-Sauri A, Forteza MJ, Chaustre F, Minana G, Gomez C (2013) Microvascular obstruction in the right ventricle in reperfused anterior myocardial infarction. Macroscopic and pathologic evidence in a swine model. Thromb Res 132(5):592–598

    Article  CAS  PubMed  Google Scholar 

  20. Abbate A, Bussani R, Sinagra G, Barresi E, Pivetta A, Perkan A et al (2008) Right ventricular cardiomyocyte apoptosis in patients with acute myocardial infarction of the left ventricular wall. Am J Cardiol 102(6):658–662

    Article  PubMed  PubMed Central  Google Scholar 

  21. Grothoff M, Elpert C, Hoffmann J, Zachrau J, Lehmkuhl L, de Waha S et al (2012) Right ventricular injury in ST-elevation myocardial infarction: risk stratification by visualization of wall motion, edema, and delayed-enhancement cardiac magnetic resonance. Circ Cardiovasc Imaging 5(1):60–68

    Article  PubMed  Google Scholar 

  22. Kanovsky J, Kala P, Novotny T, Benesova K, Holicka M, Jarkovsky J et al (2016) Association of the right ventricle impairment with electrocardiographic localization and related artery in patients with ST-elevation myocardial infarction. J Electrocardiol 49(6):907–910

    Article  PubMed  Google Scholar 

  23. Herrmann J (2010) Leave me alone: the right ventricle in anterior myocardial infarction. Cardiovasc Res 87(4):585–586

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, Tibbiye Street, Uskudar, Istanbul, Turkey

    Muhammed Keskin, Mert İlker Hayıroğlu & Tufan Çınar

  2. Department of Cardiology, Dortyol State Hospital, Hatay, Turkey

    Ahmet Okan Uzun

  3. Department of Cardiology, Duzce University, Duzce, Turkey

    Adnan Kaya

  4. Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

    Ömer Kozan

Authors
  1. Muhammed Keskin
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  2. Ahmet Okan Uzun
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  3. Mert İlker Hayıroğlu
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  4. Adnan Kaya
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  5. Tufan Çınar
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  6. Ömer Kozan
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Correspondence to Muhammed Keskin.

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Keskin, M., Uzun, A.O., Hayıroğlu, M.İ. et al. The association of right ventricular dysfunction with in-hospital and 1-year outcomes in anterior myocardial infarction. Int J Cardiovasc Imaging 35, 77–85 (2019). https://doi.org/10.1007/s10554-018-1438-6

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  • DOI: https://doi.org/10.1007/s10554-018-1438-6

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