BACKGROUND: The right ventricle (RV) has historically received less attention than its counterpart of the left side of the heart, yet there is a substantial body of evidence showing that RV size and function are perhaps equally important in predicting adverse outcomes in cardiovascular diseases. AIM: The aim of our work was to evaluate incidence and impact of right ventricular (RV) affection in patients with acute left ventricular myocardial infarction subjected to primary percutaneous coronary intervention (1ry PCI). METHODS: The study was conducted on 80 patients who had acute left ventricle ST elevated myocardial infarction (LV STEMI) and subjected to 1ry PCI. The study was done in Cairo University, critical care department. All patients were studied within 2 days after 1ry PCI, RV function was assessed by echocardiography through tricuspid annular plane systolic excursion (TAPSE) and speckle tracking echocardiography. We excluded patients with RV infarction, moderate to severe tricuspid regurgitation, pulmonary hypertension, dilated cardiomyopathy, atrial or ventricular septal defect, and patients who had cardiac dysrhythmias. RESULTS: Out of 80 patients (64 men and 16 women) included in the study, 38 patients (47.5%) had TAPSE <1.7 cm, and 48 patients (60%) had RV longitudinal strain less negative than −19%.There was a statistically significant relationship between RV affection and anterior STEMI, left anterior descending artery as an infarct-related artery, duration of intensive care unit stay, impairment of LV global and regional systolic function, in-hospital complications, and 1-year mortality. CONCLUSION: RV dysfunction is not uncommon in acute LV STEMI when using the definition of TAPSE <17 cm and RV longitudinal strain less negative than −19%.There was a significant relationship between RV dysfunction and poor outcome in patients with acute LV STEMI.

Background: An acute myocardial infarction, particularly one that is large and transmural, can produce alterations in the topography of both the infarcted and noninfarcted regions of the ventricle. Cardiac remodeling after acute myocardial infarction (AMI) is characterized by molecular and cellular mechanisms involving both left and right ventricles. Objective: To study the right ventricular affection in patients with acute myocardial infarction of the left ventricle and treated with primary PCI. Methods: The study was done in the critical care department, Cairo University (in which 2,500 primary percutaneous coronary interventions (PCIs) are done annually). Forty patients with acute ST-elevation myocardial infarction (STEMI) were subjected to primary (PCI), we excluded all patients with RV infarction and patients with pulmonary hypertension. RV function was assessed by first pass radionuclide angiocardiography within 48 hours of admission. Results: Regarding the incidence of right ventricular dysfunction in patients with acute left ventricular STEMI who treated with 1ry PCI, there were 21 patients (52.5%) with RV EF% < 40%, 16 patients (40%) with RV peak emptying rate (PER) < 1.9 EDV/s, 18 patients (45%) with RV peak filing rate (PFR) < 2.5 EDV/s and 19 patients (47.5%) with RV time to peak filling rate (TPFR) > 180 msec. There was a significant relationship between right ventricular dysfunction and duration of ICU stay, impairment of LV systolic function, failure of complete resolution of ST segment elevation, failure of early peaking of cardiac enzymes, occurrence of in-hospital complications and one year mortality. Conclusion: The incidence of right ventricular dysfunction in patients with acute left ventricular STEMI is higher than expected and has a negative impact on their outcome.