Impact of right ventricular diastolic dysfunction on clinical outcomes in inferior STEMI.
Auswirkungen rechtsventrikulärer diastolischer Dysfunktion auf klinischen Verlauf bei inferiorem STEMI.
In-hospital mortality
Percutaneous coronary intervention
Prognostic factors
Right ventricular dysfunction
ST segment elevation myocardial infarction
Journal
Herz
ISSN: 1615-6692
Titre abrégé: Herz
Pays: Germany
ID NLM: 7801231
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
19
05
2017
accepted:
13
09
2017
revised:
03
08
2017
pubmed:
11
10
2017
medline:
3
10
2019
entrez:
11
10
2017
Statut:
ppublish
Résumé
The aim of this study was to investigate the prognostic value of restrictive right ventricular filling pattern (RRVFP) in patients with the first acute inferior wall myocardial infarction (IWMI) complicated by right ventricular myocardial infarction (RVMI) undergoing primary percutaneous coronary intervention (p-PCI). A total of 152 patients with acute IWMI complicated by RVMI undergoing p‑PCI were divided into two groups according to the presence of RRVFP. RRVFP was defined as tricuspid diastolic early/late flow velocities (Et/At) > 2 and Et deceleration time (DT) < 120 ms. There were 23 patients with RRVFP in the study cohort. At, DTt, isovolumetric relaxation time (IVRT), and tissue Doppler tricuspid annular late velocity (A't) were reduced significantly in patients with RRVFP than in those without RRVFP (At 19.6 ± 2.7 vs. 39.1 ± 7.4 cm/s, p < 0.001; DTt 106 ± 13 vs.156 ± 21 ms, p = 0.001; IVRT 59 ± 6.7 vs. 62 ± 7.4 ms, p = 0.01; A't 4.6 ± 1.1 vs. 8.6 ± 1.05, p = 0.001). Et/At ratios were higher in patients with RRVFP than in those without RRVFP (Et/At 2.20 ± 0.2 vs. 1.15 ± 0.37, p < 0.001). Et, tissue Doppler tricuspid annular early velocity (E't), E't/A't ratio, and Et/E't ratio were not significantly different between groups (Et 43.3 ± 5.4 vs. 40.7 ± 9.2 cm/s p = 0.18; E't 8.8 ± 1.4 vs. 9.5 ± 2.3, p = 0.15; E't/A't 1.08 ± 0.24 vs. 1.13 ± 0.30, p = 0.52; Et/E't ratio 5.0 ± 1.1 vs. 4.5 ± 1.5 p = 0.09). Presence of E't/A't > 2, short DTt, RRVFP, unsuccessful p‑PCI, and cardiogenic shock on admission were independent predictors of in-hospital mortality (p < 0.05) in multivariable logistic regression analysis. Presence of RRVFP is associated with in-hospital mortality in patients presenting with their first IWMI complicated by RVMI.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to investigate the prognostic value of restrictive right ventricular filling pattern (RRVFP) in patients with the first acute inferior wall myocardial infarction (IWMI) complicated by right ventricular myocardial infarction (RVMI) undergoing primary percutaneous coronary intervention (p-PCI).
METHOD
METHODS
A total of 152 patients with acute IWMI complicated by RVMI undergoing p‑PCI were divided into two groups according to the presence of RRVFP. RRVFP was defined as tricuspid diastolic early/late flow velocities (Et/At) > 2 and Et deceleration time (DT) < 120 ms.
RESULTS
RESULTS
There were 23 patients with RRVFP in the study cohort. At, DTt, isovolumetric relaxation time (IVRT), and tissue Doppler tricuspid annular late velocity (A't) were reduced significantly in patients with RRVFP than in those without RRVFP (At 19.6 ± 2.7 vs. 39.1 ± 7.4 cm/s, p < 0.001; DTt 106 ± 13 vs.156 ± 21 ms, p = 0.001; IVRT 59 ± 6.7 vs. 62 ± 7.4 ms, p = 0.01; A't 4.6 ± 1.1 vs. 8.6 ± 1.05, p = 0.001). Et/At ratios were higher in patients with RRVFP than in those without RRVFP (Et/At 2.20 ± 0.2 vs. 1.15 ± 0.37, p < 0.001). Et, tissue Doppler tricuspid annular early velocity (E't), E't/A't ratio, and Et/E't ratio were not significantly different between groups (Et 43.3 ± 5.4 vs. 40.7 ± 9.2 cm/s p = 0.18; E't 8.8 ± 1.4 vs. 9.5 ± 2.3, p = 0.15; E't/A't 1.08 ± 0.24 vs. 1.13 ± 0.30, p = 0.52; Et/E't ratio 5.0 ± 1.1 vs. 4.5 ± 1.5 p = 0.09). Presence of E't/A't > 2, short DTt, RRVFP, unsuccessful p‑PCI, and cardiogenic shock on admission were independent predictors of in-hospital mortality (p < 0.05) in multivariable logistic regression analysis.
CONCLUSION
CONCLUSIONS
Presence of RRVFP is associated with in-hospital mortality in patients presenting with their first IWMI complicated by RVMI.
Identifiants
pubmed: 28993840
doi: 10.1007/s00059-017-4631-9
pii: 10.1007/s00059-017-4631-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
155-160Références
Circulation. 1999 Aug 17;100(7):761-7
pubmed: 10449700
J Am Coll Cardiol. 2001 Jan;37(1):37-43
pubmed: 11153770
Echocardiography. 1998 Feb;15(2):201-210
pubmed: 11175031
J Am Coll Cardiol. 2001 Mar 1;37(3):793-9
pubmed: 11693754
Clin Cardiol. 2002 Apr;25(4):181-6
pubmed: 12000076
J Am Coll Cardiol. 2002 Sep 4;40(5):841-53
pubmed: 12225706
Am J Cardiol. 2003 Mar 1;91(5):527-31
pubmed: 12615254
J Am Coll Cardiol. 2003 Apr 16;41(8):1273-9
pubmed: 12706920
Chest. 2003 Jul;124(1):219-26
pubmed: 12853526
J Am Soc Echocardiogr. 1992 Sep-Oct;5(5):497-503
pubmed: 1389218
J Am Soc Echocardiogr. 2004 Jul;17(7):788-802
pubmed: 15220909
J Am Coll Cardiol. 1992 Mar 1;19(3):704-11
pubmed: 1538031
Am J Cardiol. 2005 May 1;95(9):1039-42
pubmed: 15842967
Am Heart J. 2007 Feb;153(2):231-7
pubmed: 17239681
Am J Cardiol. 2007 Feb 15;99(4):431-5
pubmed: 17293178
Crit Care Med. 2008 Jul;36(7):2023-33
pubmed: 18552681
J Am Coll Cardiol. 1991 Nov 15;18(6):1564-72
pubmed: 1939962
Angiology. 2010 Feb;61(2):179-83
pubmed: 19625269
Echocardiography. 2010 May;27(5):539-43
pubmed: 20412273
J Am Soc Echocardiogr. 2010 Jul;23(7):685-713; quiz 786-8
pubmed: 20620859
Postgrad Med J. 2010 Dec;86(1022):719-28
pubmed: 20956396
J Cardiovasc Med (Hagerstown). 2011 Apr;12(4):264-7
pubmed: 21372739
Echocardiography. 2011 Mar;28(3):311-9
pubmed: 21395666
Eur Heart J Cardiovasc Imaging. 2013 Oct;14(10):1002-9
pubmed: 23345256
J Am Soc Echocardiogr. 2014 Mar;27(3):223-9
pubmed: 24412341
Am Heart J. 1988 Oct;116(4):1058-63
pubmed: 3051981
J Am Coll Cardiol. 1985 May;5(5):1155-60
pubmed: 3989126
Am Heart J. 1983 Mar;105(3):393-401
pubmed: 6829401
Am Heart J. 1977 Feb;93(2):210-5
pubmed: 835464
J Am Coll Cardiol. 1997 Dec;30(7):1618-24
pubmed: 9385885
Circulation. 1999 Jan 19;99(2):230-6
pubmed: 9892588