[Serial assessment of right ventricular function in the acute and convalescent stages after successful reperfusion: relationship to infarct-related coronary artery].
OBJECTIVE
To elucidate the relationship between the infarct-related coronary artery and the right ventricular function before and after successful recanalization.


METHODS
Hemodynamics and right ventricular function were measured using a REF-1 thermodilution catheter before and shortly after recanalization and during the convalescent stage in 35 patients, 17 with anteroseptal and 18 with inferior acute myocardial infarction.


RESULTS
Pulmonary arterial pressure significantly decreased in both anteroseptal and inferior myocardial infarction patients after recanalization. Right ventricular volume index in patients with anteroseptal myocardial infarction increased after recanalization, but again decreased during convalescence. The right ventricle became enlarged in patients with inferior myocardial infarction to maintain the right ventricular stroke volume constant. Right ventricular ejection fraction (RVEF) did not significantly change in patients with inferior myocardial infarction during convalescence (38 +/- 13%, 38 +/- 13%, 46 +/- 9%), whereas RVEF in patients with anteroseptal myocardial infarction temporarily decreased after recanalization, and then increased during convalescence (37 +/- 10%, 31 +/- 12%, 41 +/- 7%). Patients with inferior myocardial infarction were divided into two groups, patients with increased RVEF (n = 6) and decreased RVEF (n = 12) shortly after recanalization. Patients with increased RVEF showed significantly improved RVEF during convalescence (49 +/- 7% vs 37 +/- 6%, p < 0.05). The increase in RVEF shortly after recanalization in patients with inferior myocardial infarction was an independent factor for predicting RVEF during convalescence.


CONCLUSIONS
Patients with anteroseptal myocardial infarction showed a different pattern of change in the right ventricular function during the acute and convalescent stages. An early change in RVEF in patients with inferior myocardial infarction can predict RVEF in the convalescent stage.
Sakuma
Tadamichi
T
Cardiovascular Division, Department of Internal Medicine, Box 800158, Medical Center, University of Virginia, Charlottesville, VA 22908, USA.
Hayashi
Yasuhiko
Y
D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D003289:Convalescence; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D009204:Myocardial Revascularization; D013318:Stroke Volume; D013815:Thermodilution; D016278:Ventricular Function, Right / Q000502:physiology*