Assessment of right ventricular function in acute inferior myocardial infarction using 133-xenon imaging.
The detection of right ventricular dysfunction in acute inferior myocardial infarction is important because of its potentially serious consequences which may be remediable with the appropriate therapeutic manoeuvres. A technique has been developed to assess right ventricular function using 133-xenon. This technique was applied to 26 patients who had sustained an acute inferior myocardial infarction. Right ventricular ejection fractions ranged from 7-54%, mean 30 +/- 11%, which was significantly lower than values obtained from normal volunteers (n = 21), mean 43 +/- 5%, and patients with arteriographically proven coronary artery disease without previous myocardial infarction (n = 12), mean 39 +/- 9%, P less than 0.001, and P less than 0.001, respectively. In the patients with acute inferior myocardial infarction 18 patients (69%) had evidence of right ventricular dysfunction (right ventricular ejection fraction less than 35%). 13/26 patients (50%) had clinical evidence of right ventricular dysfunction with a mean right ventricular ejection fraction 26 +/- 11% (range 7-54%) which was significantly lower than the patients without evidence of right ventricular dysfunction, mean 35 +/- 9% (range 16-49%), P less than 0.001. The clinical signs had a sensitivity of 72% (13/18), a specificity of 87.5% (7/8) and a predictive accuracy of 76% (20/26) when compared to the imaging data.


CONCLUSIONS
(1) gated 133-xenon imaging provides a method for assessing right ventricular function in the setting of acute myocardial infarction; (2) a wide spectrum of right ventricular dysfunction occurs following inferior myocardial infarction which may not manifest itself clinically.
McGhie
I
I
Department of Medical Cardiology, Royal Infirmary, Glasgow, U.K.
Martin
W
W
Tweddel
A
A
Hutton
I
I
D000328:Adult; D000368:Aged; D002302:Cardiac Output; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging; D003327:Coronary Disease / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes