Right ventricular dysfunction after thrombolysis in patients with right ventricular infarction.
BACKGROUND
Right ventricular (RV) infarction is frequently associated with highest risk of death and major complications. Doppler echocardiography can be useful in the diagnosis of RV involvement. The goal of this study was to evaluate Doppler echocardiography features associated with RV involvement and a poor prognosis.


METHODS
Two-dimensional Doppler echocardiography was performed before and after thrombolysis in 108 consecutive patients with an RV infarction. The bedside examination was performed before and 2 to 3 hours after thrombolytic therapy, and repeated after 1 and 7 days. All patients underwent coronary angiography after 20 days, and the perfusion of the coronary-related artery (> thrombolysis in myocardial infarction [TIMI] 3 grade) was evaluated.


RESULTS
Patients were divided into 2 groups according to the recovery of global and regional RV function after thrombolytic therapy. In the group of patients who showed a normalization or improvement of RV wall motion (as assessed by RV wall motion score index), we found a TIMI grade III perfusion in 78% of patients. The analysis of interatrial septal motion and interventricular septal motion showed a normalization in all reperfused patients. Major complication and deaths were more frequent in patients with echocardiographic findings of RV dysfunction persisting after thrombolytic therapy.


CONCLUSIONS
In patients with RV infarction treated with thrombolysis, persistent RV dysfunction is associated with a higher risk for the development of major cardiac complications and death.
Mattioli
A V
AV
Department of Cardiology, University of Modena and Reggio Emilia, Italy. mattioli.annavittoria@unimo.it
Fini
M
M
Mattioli
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G
D000368:Aged; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D018497:Ventricular Dysfunction, Right / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology
D005343:Fibrinolytic Agents