title: Right ventricular systolic function as a marker of prognosis after ST-elevation inferior myocardial infarction 5-year follow-up.
abstract: BACKGROUND
  There is scarce data about clinical value of right ventricular (RV) systolic function assessed in pre-discharge transthoracic echocardiography for predicting long-term prognosis in patients with inferior ST-elevation myocardial infarction (MI).
  
  
  METHODS
  The aim of this study was to assess correlations of RV function parameters in patients after inferior ST-elevation MI with preserved or mildly impaired left ventricular ejection fraction with prognosis during 5-year follow-up. Primary endpoint was death from any cause or unscheduled hospitalization for cardiac causes (unstable angina/MI, percutaneous coronary intervention/coronary artery bypass grafting due to progression of coronary artery disease, heart failure exacerbation or pacemaker implantation), secondary endpoints were all listed above components analyzed separately. RV systolic function was measured with pulsed tissue Doppler as systolic myocardial velocity at the basal segment of RV free wall in the acute phase and pre-discharge echocardiography.
  
  
  RESULTS
  Follow-up was conducted in 86 consecutive patients (mean age 61±10years, 74% males). Multivariate regression analysis revealed that only RV systolic function in pre-discharge echocardiography correlated independently with the primary endpoint (OR 0.56, 95% CI 0.34-0.92, p=0.02). A positive predictive value of 44% and a negative predictive value of 83% (sensitivity 80%, specificity 49%, AUC 0.7) for predicting the primary endpoint was established for RV systolic myocardial velocity<13cm/s in pre-discharge echocardiography.
  
  
  CONCLUSIONS
  In patients after inferior wall ST-elevation MI with preserved or slightly impaired LV systolic function, pre-discharge RV systolic dysfunction correlated independently with worse long-term prognosis.
authors.affiliation: Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland. Electronic address: krzysztofsmarz@hotmail.com.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Smarz
authors.affiliation: Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Zaborska
authors.affiliation: Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jaxa-Chamiec
authors.affiliation: Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Tysarowski
authors.affiliation: Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Budaj
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D013995:Time; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology
keywords: Echocardiography; Myocardial infarction; Prognosis; Right ventricle