title: Angiographic result of index PCI determines the presence of right ventricular infarction in patients with acute inferior myocardial infarction.
abstract: It is still a matter of debate which patients with acute inferior myocardial infarction are at increased risk of developing right ventricular (RV) myocardial infarction (RVMI). Cardiac magnetic resonance imaging (CMRI) with late enchancement (LE) is regarded as the gold standard for RVMI assessment. We aimed to determine the impact of initial angiographic status and salutary effect of primary percutaneous coronary intervention (PCI) on the presence of RVMI. In 114 patients undergoing emergency angiography and primary PCI of right coronary artery, 3-5 days after index PCI, LE CMRI was performed for assessing the RVMI. Forty-eight patients (42%) demonstrated RVMI. Multivariate regression analysis identified TIMI flow <2 in at least one RV branch after PCI as an independent angiographic predictor of RVMI [odds ratio (OR) 143.00, 95% confidence interval (CI) 18.10-1130.05, p < 0.001]. ST-segment elevation ≥ 1 mm in V4R was present in 83 (73%). TIMI flow <3 in at least one RV branch before PCI (OR 4.07, 95% CI 1.24-13.33, p = 0.02) was independent angiographic predictor of ST-segment elevation ≥ 1 mm in V4R. The only predictor of RVMI was TIMI flow <2 in at least one RV branch after PCI. ST-segment elevation ≥ 1 mm in V4R is caused by TIMI <3 flow in at least one RV branch before index PCI.
authors.affiliation: Department of Interventional Cardiology, John Paul II Hospital, Jagiellonian University Medical College, Prądnicka 80, 31-202, Kraków, Poland. marektomala@gmail.com.
authors.forename: Marek
authors.initials: M
authors.lastname: Tomala
authors.affiliation: Department of Radiology and Imaging Diagnostics, John Paul II Hospital, Kraków, Poland.|Department of Clinical Radiology and Imaging Diagnostics, 4th Military Hospital, Wrocław, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Miszalski-Jamka
authors.affiliation: Department of Interventional Cardiology, John Paul II Hospital, Jagiellonian University Medical College, Prądnicka 80, 31-202, Kraków, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zajdel
authors.affiliation: Department of Interventional Cardiology, John Paul II Hospital, Jagiellonian University Medical College, Prądnicka 80, 31-202, Kraków, Poland.
authors.forename: Bartłomiej
authors.initials: B
authors.lastname: Nawrotek
authors.affiliation: The Lindner Center for Research and Education, The Christ Hospital Heart and Vascular Center, Cincinnati, OH, USA.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Mazur
authors.affiliation: The Lindner Center for Research and Education, The Christ Hospital Heart and Vascular Center, Cincinnati, OH, USA.
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Kereiakes
authors.affiliation: Department of Interventional Cardiology, John Paul II Hospital, Jagiellonian University Medical College, Prądnicka 80, 31-202, Kraków, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D009336:Necrosis; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute myocardial infarction; Cardiac magnetic resonance imaging; Primary percutaneous coronary intervention; Right ventricle infarction