title: Effect of reperfusion on biventricular function and survival after right ventricular infarction.
abstract: BACKGROUND
  Although the salutary effects of reperfusion in patients with left ventricular infarction are well documented, the benefits in patients with acute right ventricular infarction are less clear.
  
  
  METHODS
  To determine whether primary angioplasty improves right ventricular function and the clinical outcome in patients with right ventricular infarction, we performed echocardiographic studies before and after angioplasty in 53 patients with acute right ventricular infarction.
  
  
  RESULTS
  Complete reperfusion, defined as normal flow in the right main coronary artery and its major right ventricular branches, was achieved in 41 patients (77 percent), leading to prompt and striking recovery of right ventricular function (mean [+/-SE] score for free-wall motion, 3.0+/-0.1 at base line and 1.4+/-0.1 at three days; P<0.001). Twelve patients (23 percent) had unsuccessful reperfusion, defined as the failure to restore right ventricular branch flow, with or without patency of the right main coronary artery. Unsuccessful reperfusion was associated with lack of recovery of right ventricular function (score for free-wall motion, 3.2+/-0.2 at base line and 3.0+/-0.9 at three days; P= 0.55), as well as persistent hypotension and low cardiac output (in 83 percent of the patients, vs. 12 percent of those with successful reperfusion; P=0.002) and a high mortality rate (58 percent, vs. 2 percent for those with successful reperfusion; P=0.001).
  
  
  CONCLUSIONS
  In patients with right ventricular infarction, complete reperfusion of the right coronary artery by angioplasty results in the dramatic recovery of right ventricular performance and an excellent clinical outcome. In contrast, unsuccessful reperfusion is associated with impaired recovery of right ventricular function, persistent hemodynamic compromise, and a high mortality rate.
authors.affiliation: Division of Cardiology, William Beaumont Hospital, Royal Oak, MI 48073-6769, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Bowers
authors.forename: W W
authors.initials: WW
authors.lastname: O'Neill
authors.forename: C
authors.initials: C
authors.lastname: Grines
authors.forename: M C
authors.initials: MC
authors.lastname: Pica
authors.forename: R D
authors.initials: RD
authors.lastname: Safian
authors.forename: J A
authors.initials: JA
authors.lastname: Goldstein
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003326:Coronary Circulation; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000401:mortality; D016278:Ventricular Function, Right