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Antoni, M.L.; Scherptong, R.W.C.; Atary, J.Z.; Boersma, E.; Holman, E.R.; Wall, E.E. van der; ... ; Bax, J.J. (2010)

Prognostic Value of Right Ventricular Function in Patients After Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Article / Letter to editor
Background-Data on the association between right ventricular (RV) function and adverse events after acute myocardial infarction (AMI) are scarce. The purpose of the current study was to evaluate the relation between RV function and adverse events in patients treated with primary percutaneous coronary intervention for AMI. Methods and Results-Consecutive patients admitted with AMI treated with primary percutaneous coronary intervention underwent echocardiography within 48 hours of admission to assess left ventricular and RV function. RV function was quantified with RV fractional area change (RVFAC), tricuspid annular plane systolic excursion, and RV strain. The end point was defined as a composite of all-cause mortality, reinfarction, and hospitalization for heart failure. All patients (n = 621) were followed prospectively, and during a mean follow-up of 24 months, 86 patients reached the composite end point. RVFAC, tricuspid annular plane systolic excursion, and RV strain were all...Show moreBackground-Data on the association between right ventricular (RV) function and adverse events after acute myocardial infarction (AMI) are scarce. The purpose of the current study was to evaluate the relation between RV function and adverse events in patients treated with primary percutaneous coronary intervention for AMI. Methods and Results-Consecutive patients admitted with AMI treated with primary percutaneous coronary intervention underwent echocardiography within 48 hours of admission to assess left ventricular and RV function. RV function was quantified with RV fractional area change (RVFAC), tricuspid annular plane systolic excursion, and RV strain. The end point was defined as a composite of all-cause mortality, reinfarction, and hospitalization for heart failure. All patients (n = 621) were followed prospectively, and during a mean follow-up of 24 months, 86 patients reached the composite end point. RVFAC, tricuspid annular plane systolic excursion, and RV strain were all univariable predictors of worse outcome. After multivariable analysis, only RVFAC (hazard ratio, 0.96; 95% CI, 0.92 to 0.99) and RV strain (hazard ratio, 1.08; 95% CI, 1.03 to 1.13) independently predicted the composite end point. In addition, RV strain provided incremental value to clinical information, infarct characteristics, left ventricular function, and RVFAC. Conclusions-RV function provides strong prognostic information in patients treated with primary percutaneous coronary intervention for AMI. (Circ Cardiovasc Imaging. 2010; 3: 264-271.)Show less
echocardiography myocardial infarction prognosis tissue doppler cardiovascular-disease systolic function european-society heart-failure echocardiography strain involvement motion recommendations
All authors
Antoni, M.L.; Scherptong, R.W.C.; Atary, J.Z.; Boersma, E.; Holman, E.R.; Wall, E.E. van der; Schalij, M.J.; Bax, J.J.
Date
2010-05-31
Journal
Circulation: Cardiovascular Imaging
Volume
3
Issue
3
Pages
264 - 271
DOI
doi:10.1161/CIRCIMAGING.109.914366