The state of systolic function and diastolic filling of the myocardium in patients with right ventricular myocardial infarction on the background of the Q-wave myocardial infarction of the left ventricle during 6 months of follow-up
Background. Remodeling after right ventricular myocardial infarction (RV MI) is associated with a poor prognosis. The aim of the study is to evaluate the dynamics of the postinfarction remodeling and the diastolic dysfunction of the left (LV) and right ventricle in patients with RV MI on the background of the Q-MI of the LV and their relationship with the heart failure progression within 6 months of follow-up. Materials and methods. 309 patients with the Q-MI aged 65.50 ± 4.42 years were examined. 155 patients with RV MI on the background the Q-MI of LV posterior wall were included into the 1st group; 2nd group consisted of 53 patients with the RV MI due the Q-MI of the LV of circular localization, and the control group — of 101 patients with the Q-MI of the LV posterior wall. Doppler echocardiography was performed on day 4–5 of acute MI and 6 months after the MI. Results. In patients with RV MI in the acute period, pseudonormal and restrictive type of diastolic dysfunction of the LV and RV (p < 0.05) prevailed, which were formed on the background of significant dilatation of the left and right atrium of the LV and RV (p < 0.05), lower contractility of the LV and RV and increased systolic pressure in the pulmonary artery (p < 0.05) that was associated with a high incidence of fatal arrhythmias (p < 0.05) and severe manifestations of acute heart failure, in particular, the Killip III and cardiogenic shock, as compared with the control group (p < 0.05). The positive dynamics of systolic and diastolic function of the LV and RV was observed after 6 months; in particular, there were cases of diastolic function normalization and prevalence of the relaxation type of the diastolic dysfunction (p < 0.05). Despite this, in patients suffered from RV MI, the progression of heart failure was detected: the IIA stage and the New York Heart Association class III (p < 0.05) were diagnosed more often compared with the control group. Conclusions. The RV MI on the background of the Q-MI of the LV were accompanied by more severe disturbances of the systolic and diastolic function of the LV and RV and associated with a high incidence of fatal arrhythmias, pulmonary edema and cardiogenic shock in the acute period, as well as with the progression of heart failure within 6 months of follow-up.
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Firoozeh Abtahi, Mahkameh Farmanesh, Alireza Moaref, Shahnaz Shekarforoush. Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction. Int Cardiovasc Res J.2016;10(2):67-71. doi: 10.17795/icrj-10(2)67
T Ondrus, J Kanovsky, T Novotny, I Andrsova, J Spinar, P Kala. Right ventricular myocardial infarction: From pathophysiology to prognosis. Exp Clin Cardiol 2013;18(1):27-30. PMCID: PMC3716484
Dima C., E.H. Yang. Right Ventricular Infarction. Medscape Cardiology. Режим доступу: http://emedicine.medscape.com/article/157961-overview
Jensen CJ, Jochims M, Hunold P, Sabin GV, Schlosser T, Bruder O. Right ventricular involvement in acute left ventricular myocardial infarction: prognostic implications of MRT findings. AJR Am J Roentgenol. 2010 Mar;194(3):592-8. doi: 10.2214/AJR.09.2829.
Taku Inohara, Shun Kohsaka, Keiichi Fukuda and Venu Menon. The challenges in the management of right ventricular infarction. European Heart Journal: Acute Cardiovascular Care 2(3) 226–234. DOI: 10.1177/2048872613490122
Michael Pavlicek, Andreas Wahl, Tobias Rutz, Stefano F. de Marchi, Ron Hille, Kerstin Wustmann, He´le`ne Steck, Christina Eigenmann, Markus Schwerzmann, and Christian Seiler. Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging. European Journal of Echocardiography (2011) 12, 871–880 doi:10.1093/ejechocard/jer138
Lopez-Sendon J, Garcia-Fernandez MA, Coma-Canella I, et al. Segmental right ventricular function after acute myocardial infarction: 2-dimensional echocardiographic study in 63 patients. Am J Cardiol 1983; 51:390–396
Eric Larose, Peter Ganz, H. Glenn Reynolds, Sharmila Dorbala, Marcelo F. Di Carli, Kenneth A. Brown, Raymond Y. Kwong. Right Ventricular Dysfunction Assessed by Cardiovascular Magnetic Resonance Imaging Predicts Poor Prognosis Late After Myocardial Infarction. Journal of the American College of Cardiology. Vol. 49, No. 8, 2007: 855-62. doi:10.1016/j.jacc.2006.10.056
Zornoff LA, Skali H, Pfeffer MA, St John Sutton M, Rouleau JL, Lamas GA, Plappert T, Rouleau JR, Moyé LA, Lewis SJ, Braunwald E, Solomon SD. Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J Am Coll Cardiol. 2002 May 1;39(9):1450-5. PMID: 11985906
Gopalan Nair Rajesh, Deepak Raju, Deepak Nandan, Vellani Haridasan, Desabandhu Vinayakumar, Kader Muneer, C.G. Sajeev, Kadangot Babu, M.N. Krishnan. Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis. Indian Heart Journal. – 2013. Vol. 65. – P. 522 - 528: http://dx.doi.org/10.1016/j.ihj.2013.08.021
Dokainish H, Abbey H, Gin K, Ramanathan K, Lee PK, Jue J. Usefulness of tissue Doppler imaging in the diagnosis and prognosis of acute right ventricular infarction with inferior wall acute left ventricular infarction. Am J Cardiol. 2005 May 1;95(9):1039-42. DOI: 10.1016/j.amjcard.2004.12.056
Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K,Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, van 't Hof A, Widimsky P, Zahger D. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J. 2012 Oct;33(20):2569-619. doi: 10.1093/eurheartj/ehs215.
Ponikowski P., Voors AA, Stefan D. Anker, He´ctor Bueno, John G. F. Cleland, Andrew J. S. Coats, Volkmar Falk, Jose´ Ramo´n Gonza´lez-Juanatey, Veli-Pekka Harjola, Ewa A. Jankowska, Mariell Jessup, Cecilia Linde, Petros Nihoyannopoulos, John T. Parissis, Burkert Pieske, Jillian P. Riley, Giuseppe M. C. Rosano, Luis M. Ruilope, Frank Ruschitzka, Frans H. Rutten, Peter van der Meer. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). European Heart Journal.2016;37:2129–2200. doi:10.1093/eurheartj/ehw128
Voronkov L.H., Amosova K.M., Bahriy A.E. ta in. Rekomendatsiyi z diahnostyky ta likuvannya khronichnoyi sertsevoyi nedostatnosti (2012) // Sertseva nedostatnist'. - 2012. - #3. - S. 60-96.
Roberto M. Lang, MD, FASE, FESC, Luigi P. Badano, MD, PhD, FESC, Victor Mor-Avi, PhD, FASE, Jonathan Afilalo, MD, MSc, Anderson Armstrong, MD, MSc, Laura Ernande, MD, PhD, Frank A. Flachskampf, MD, FESC, Elyse Foster, MD, FASE, Steven A. Goldstein, MD, Tatiana Kuznetsova, MD, PhD, Patrizio Lancellotti, MD, PhD, FESC, Denisa Muraru, MD, PhD, Michael H. Picard, MD, FASE, Ernst R. Rietzschel, MD, PhD, Lawrence Rudski. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1-39. http://dx.doi.org/10.1016/j.echo.2014.10.003
Ekhokardiohrafichna otsinka pravykh viddiliv sertsya u doroslykh. Rekomendatsiyi Robochoyi hrupy z funktsional'noyi diahnostyky Asotsiatsiyi kardiolohiv Ukrayiny ta Vseukrayins'koyi asotsiatsiyi fakhivtsiv kh ekhokardiohrafiyi / V.M. Kovalenko, O.S. Sychov, M.M. Dolzhenko M.M. ta in. // Arytmolohiya. – 2013. - # 4 – S. 27-61
Voelkel NF, Quaife RA, Leinwand LA, Barst RJ, McGoon MD, Meldrum DR, Dupuis J, Long CS, Rubin LJ, Smart FW, Suzuki YJ, Gladwin M, Denholm EM, Gail DB. Right ventricular function and failure: report of a National Heart, Lung, and Blood Institute working group on cellular and molecular mechanisms of right heart failure. Circulation. 2006 Oct 24;114(17):1883-91. DOI: 1161/CIRCULATIONAHA.106.632208
M. Louisa Antoni, MD; Roderick W.C. Scherptong, MD; Jael Z. Atary, MD; Eric Boersma, PhD; Eduard R. Holman, MD, PhD; Ernst E. van der Wall, MD, PhD; Martin J. Schalij, MD, PhD; Jeroen J. Bax, MD, PhD. Prognostic Value of Right Ventricular Function in Patients After Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. Circ Cardiovasc Imaging. 2010;3:264-271. DOI: 10.1161/CIRCIMAGING.109.914366.
Anavekar NS, Skali H, Bourgoun M, Ghali JK, Kober L, Maggioni AP, McMurray JJ, Velazquez E, Califf R, Pfeffer MA, Solomon SD. 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. 2008 Mar 1;101(5):607-12. doi: 10.1016/j.amjcard.2007.09.115.
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