ST-segment elevation in right precordial leads implies depressed right ventricular function after acute inferior myocardial infarction

Yoshino, Hideaki; Udagawa, Haruhide; Shimizu, Hisashi; Kachi, Eisei; Kajiwara, Tatsuto; Yano, Kohei; Taniuchi, Masato; Ishikawa, Kinya

doi:10.1016/s0002-8703(98)70287-x

Cited by 26 publications

(12 citation statements)

References 35 publications

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“…In addition, RV undergoes rapid changes influenced by reperfusion therapy, hemodynamic changes and reversibility of ischemia. Consequently, accurate and reproducible RV myocardial function parameters are needed to identify RV dysfunction and monitor RV remodeling [13].…”

Section: Screening Of Rv Dysfunction After Stemimentioning

confidence: 99%

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Huttin

Lemarié

Meglio

et al. 2015

Int J Cardiovasc Imaging

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To assess the pattern of right ventricular (RV) functional recovery in a cohort of patients with successful reperfusion of a first episode of acute myocardial infarction (AMI) with 2D speckle-tracking echocardiography and cardiac magnetic resonance imaging (CMR). Ninety-five revascularized AMI patients were prospectively included (56.8 ± 11.1 years, 48 inferior, 47 anterior). RV function was assessed by echocardiography and CMR within the initial 72 h and 6 months later. A RV global strain was calculated while averaging strain values from septal, lateral and inferior walls. At the acute phase, RVEFCMR was lower in inferior than in anterior AMI patients (52.5 ± 6.8 vs. 56.0 ± 4.8, p = 0.006). Similarly, RV global, inferior and lateral strains were lower in inferior MI patients (p < 0.001 for all) whereas septal strain was not significantly different across groups. At 6 months, RVEFCMR and all strain parameters improved compared to baseline. Improvements were more substantial for patients with inferior than with anterior MI. RV parameters ultimately reached similar levels in the two groups at 6 months except for inferior strain which remained lower in patients with inferior MI (-24.5 ± 6.5 vs. -27.5 ± 5.4, p = 0.03). In low risk patients after AMI, RV function ultimately recovered over the 6 months of follow up. Higher levels of both initial impairment and subsequent recovery were observed for inferior MI. Although RV function was relatively preserved in these patients, RV strain analysis revealed a persistent impairment of RV inferior strain in patients with inferior MI, which may not be identified by RVEFCMR or conventional echocardiographic parameters.

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Section: Screening Of Rv Dysfunction After Stemimentioning

confidence: 99%

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Huttin

Lemarié

Meglio

et al. 2015

Int J Cardiovasc Imaging

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“…1 Routine early diagnostics used for RVMI detection rely on electrocardiogram and standard echocardiographic recordings. 2,3,4 Considering that in patients with RVMI the risk of serious complications and death are significantly increased 5,6,7 the assessment of RV systolic function is an important challenge. Tissue Doppler echocardiography (TDE) has proven to be a simple and reproducible marker of RV function which significantly correlates with the right ventricular ejection fraction assessed by first-pass radionuclide ventriculography and magnetic resonance imaging.…”

mentioning

confidence: 99%

Right Ventricular Function Suffers From Reperfusion Delay: Tissue Doppler Study

Kidawa

Kasprzak

Wierzchowski

et al. 2010

Clinical Cardiology

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In this study, impact of reperfusion delay on adverse cardiac events and right ventricular (RV) function in patients with acute right ventricular myocardial infarction (RVMI) was assessed. In 70 patients with RVMI, RV function was assessed by M-mode tricuspid annular plane systolic excursion (TAPSE) and by pulsed wave tissue Doppler echocardiography (TDE). Right ventricular early (E T ) and late diastolic (A T ), peak systolic tricuspid annular velocity, (S T ) and right ventricular myocardial performance index (RVMPI) were measured. Patients were divided into 2 groups according to the time between the onset of symptoms and percutaneous transluminal coronary angioplasty (PTCA)-group 1 (n = 25), 3 hours and group 2 (n = 45), >3 hours. During 30-day follow-up, we assessed adverse cardiac events like the following: death, cardiogenic shock, need for intra-aortic counterpulsation, temporary transvenous pacing support (PCM), presence of ventricular septal defect (VSD), cardiac tamponade, or free wall rupture. Results: Group 1 had significantly higher values of E T , S T , and TAPSE than group 2. RVMPI was significantly elevated in group 2. A total of 13 (18.2%) patients had a cardiac event, 5 patients (7.1%) died. We observed an increase of cardiac events in patients with reperfusion delayed more than 3 hours (P = .056). Conclusion: TAPSE-derived and TDE-derived right ventricular systolic and early diastolic velocities were less affected in patients with shorter time from pain onset to opening of the occluded right coronary artery (RCA). Presented initial data show that the tissue Doppler technique may be useful for identification of patients with RV infarction with higher rate of adverse cardiac events including death.

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“…The first step when analyzing an ECG showing ST elevation is to determine whether the abnormalities are due to acute epicardial coronary artery occlusion. 4 Right-sided (V 4 R) and posterior (V 7 -V 9 ) leads would have been diagnostically useful in this case but were not obtained. ST elevation in the anterior precordial leads is also seen with hyperkalemia and the Brugada pattern.…”

Section: Commentmentioning

confidence: 82%

An Unusual Pattern of ST-Segment Elevation—Discussion

2011

Arch Intern Med

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ST-segment elevation in right precordial leads implies depressed right ventricular function after acute inferior myocardial infarction

Cited by 26 publications

References 35 publications

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography

Right Ventricular Function Suffers From Reperfusion Delay: Tissue Doppler Study

An Unusual Pattern of ST-Segment Elevation—Discussion

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