Clinical and angiographic outcome of patients with acute inferior myocardial infarction

Abstract

Primary PTCA is an appropriate reperfusion strategy in patients with RVI. Further comparative studies are required to compare the effectiveness of primary PTCA with early thrombolytic therapy in this high risk setting.

Mechanisms and Clinical Consequences of Vascular Calcification

“…Atherosclerotic calcification is the most common form of calcific vasculopathy, and occurs as early as the second decade of life just after fatty streak formation (Stary et al, 1995). Small aggregates of crystalline calcium can be detected in developing lesions, and in adults past the fourth decade of life, greater lesion areas may be calcified (Stary, 2000). The degree of calcification correlates with the extent of atherosclerosis, with age, and hypertension as dominant risk factors for systemic calcified atherosclerosis (Allison et al, 2004).…”

Usefulness of cardiac MRI in the prognosis and follow-up of ischemic heart disease

“…Whereas some authors believe that the right ventricle damage is a powerful predictor of major cardiovascular episodes during follow-up, even after the infarction size has been normalized in the left ventricle---which can have a significantly greater mortality 46,47 ; others have not shown any short-term prognostic relations in the infarction of the right ventricle. 48,49 In sum right ventricle AMI can be reliably detected through CMR yet the prognostic meaning of late enhancement in the right ventricle remains unclear.…”

The challenges in the management of right ventricular infarction

“…22 However, although the number of patients with RV infarction is small, these patients seem to have a higher risk of in-hospital mortality in the mechanical reperfusion era than during the fibrinolytic era. Figure 2 shows the changes in the in-hospital mortality rate and relative risk of RV infarction for in-hospital mortality between the fibrinolytic and mechanical reperfusion era; 8,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] An increase in the relative risk of RV infarction from 2.29 (95% CI 1.67-3.14) to 2.98 (95% CI 1.41-6.31) also occurred during this period. The precise explanation for the paradox remains unknown.…”

“…These data were derived from previously published meta-analyses, 21 which included many prospective or retrospective studies, assessing the impact of RV infarction in patients with acute MI up to June 2007, 8,[23][24][25][26][27][28][29][30][33][34][35][36] and two additional observational studies that met the same inclusion criteria up to June 2012. 31,32 of concomitant LV involvement, this study indicated that the mean optimal PWP, which corresponded to the maximum LV stroke work index in each patient, was 16 mmHg.…”

“…47,50,51 Berisha and associates, 52 in a study of 41 patients who fulfilled the diagnostic electrocardiographic and haemodynamic criteria for RV infarction, reported that the maximal RV stroke work index occurred when the filling pressure was 10-14 mmHg, and a mean RAP of >14 mmHg was almost always associated with a reduced RV stroke work index (Figure 3). Although the haemodynamic characteristics of RV infarction may be extremely variable, depending on the patient's state of hydration and the degree These data were derived from previously published meta-analyses, 21 which included many prospective or retrospective studies, assessing the impact of RV infarction in patients with acute MI up to June 2007, 8, [23][24][25][26][27][28][29][30][33][34][35][36] and two additional observational studies that met the same inclusion criteria up to June 2012. 31,32 of concomitant LV involvement, this study indicated that the mean optimal PWP, which corresponded to the maximum LV stroke work index in each patient, was 16 mmHg.…”