Prognostic value of right ventricular function in patients after acute myocardial infarction treated with primary percutaneous coronary intervention.
BACKGROUND
Data on the association between right ventricular (RV) function and adverse events after acute myocardial infarction (AMI) are scarce. The purpose of the current study was to evaluate the relation between RV function and adverse events in patients treated with primary percutaneous coronary intervention for AMI.


RESULTS
Consecutive patients admitted with AMI treated with primary percutaneous coronary intervention underwent echocardiography within 48 hours of admission to assess left ventricular and RV function. RV function was quantified with RV fractional area change (RVFAC), tricuspid annular plane systolic excursion, and RV strain. The end point was defined as a composite of all-cause mortality, reinfarction, and hospitalization for heart failure. All patients (n=621) were followed prospectively, and during a mean follow-up of 24 months, 86 patients reached the composite end point. RVFAC, tricuspid annular plane systolic excursion, and RV strain were all univariable predictors of worse outcome. After multivariable analysis, only RVFAC (hazard ratio, 0.96; 95% CI, 0.92 to 0.99) and RV strain (hazard ratio, 1.08; 95% CI, 1.03 to 1.13) independently predicted the composite end point. In addition, RV strain provided incremental value to clinical information, infarct characteristics, left ventricular function, and RVFAC.


CONCLUSIONS
RV function provides strong prognostic information in patients treated with primary percutaneous coronary intervention for AMI.
Antoni
M Louisa
ML
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Scherptong
Roderick W C
RW
Atary
Jael Z
JZ
Boersma
Eric
E
Holman
Eduard R
ER
van der Wall
Ernst E
EE
Schalij
Martin J
MJ
Bax
Jeroen J
JJ
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000000981:diagnostic imaging*