title: [Efficacy of reperfusion therapy in syndrome of predominant right ventricular dysfunction associated with inferior myocardial infarction].
abstract: Aim of the study was choice of optimal tactics of treatment of patients with syndrome of predominant right ventricular (RV) dysfunction, associated with inferior myocardial infarction. We compared immediate and remote results of 3 strategies of treatment of 100 patients admitted to N.V. Sklifosovsky Research Institute for Critical Care in 2003-2007: various methods of percutaneous coronary intervention (PCI), including delayed PCI in the acute period (n=48), thrombolytic therapy without subsequent PCI (n=20), conservative therapy without reperfusion therapy (n=32). Indications to delayed interventions were based on high risk of death due to RV infarction. It follows from the data obtained that optimal tactics of treatment of RV infarction is provision of availability of reperfusion therapy in the form of various types of PCI. Preferable are primary PCIs in the absence of which delayed PCIs acquire practical value. Thrombolytic therapy can be used as a component of combined reperfusion. Absence of signs of its efficacy on electrocardiogram during first 90 minutes serves as absolute indication for rescue PCI. Inaccessibility of the latter is a reason for provision of delayed interventions. Electrocardiographic signs of achieved pharmacological reperfusion do not exclude high probability of early recurrences of ischemia, expediency of application of PCI during the time preceding these recurrences. In the absence of PCI hospital and remote mortality have been very high. Optimization of accessibility of mechanical reperfusion including delayed allows to achieve efficacy of treatment of RV infarction, prevent development of complications and lethal outcomes.
authors: S G
authors: SG
authors: Evstratova
authors: G A
authors: GA
authors: Gazarian
authors: I V
authors: IV
authors: Zakharov
authors: D A
authors: DA
authors: Chepkiĭ
authors: G A
authors: GA
authors: Nefedova
authors: A P
authors: AP
authors: Golikov
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D013577:Syndrome; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology