Subtle Right Ventricular Affection in Patients with Acute Myocardial Infarction, Echocardiographic Assessment

Mohamed, Abdallah S.R.; Alramlawy, Shaaban; Elhadidy, Samir; Affify, Mohamed; Radwan, Waheed

doi:10.3889/oamjms.2020.4430

Cited by 4 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mohamed et al [ 23 ] excluded patients with electrocardiographic evidence of RV infarction and enrolled 80 patients with anterior STEMI who were subjected to PPCI. RV functions were assessed using strain by speckle tracking, which revealed a significant relationship between RV affection and anterior STEMI, which was consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

Early right ventricular dysfunction after primary percutaneous coronary intervention in anterior versus isolated inferior myocardial infarction assessed by tissue Doppler imaging and speckle tracking echocardiography

Radwan

Alhoseeny²,

Ghoniem³

et al. 2022

Heart Fail Rev

View full text Add to dashboard Cite

This study hypothesized that imaging provides information indicating the right ventricular (RV) involvement after anterior or inferior ST-elevation myocardial infarction (STEMI), beyond standard electrocardiogram (ECG) due to the increasing interest in RV function and assessment techniques. This study aimed to compare RV function between anterior and inferior MI without RV involvement using different echocardiographic modalities. This study included 100 patients with anterior (50 patients) and inferior (50 patients) STEMI, who underwent primary percutaneous coronary intervention (PPCI) and two-dimensional echocardiographic imaging within 24 h after PPCI with RV function analysis by left ventricular (LV) infarct size, LV filling pressure, and RV strain rate. Our primary endpoint was the subclinical RV dysfunction in anterior or inferior MI using tissue Doppler and speckle tracking (STE). The study population included 80 (80%) males and 20 (20%) females. Patients with the anterior STEMI had higher mean creatine kinase-MB (CKMB) and troponin than those with inferior STEMI. This study revealed worse RV dysfunction in patients with anterior than those with inferior STEMI, as reflected by significantly lower RV systolic function, tricuspid annular plane systolic excursion (p ≤ 0.0001), tissue Doppler-derived velocity (p ≤ 0.0001), and STE-derived strain magnitude and rate (p ≤ 0.0001). RV dysfunction occurs in patients without ECG evidence of RV STEMI. RV dysfunction is worse in anterior than inferior MI. Moreover, RV systolic functions were affected by declined LV ejection fraction irrespective of the infarction site, which clinically implies prognostic, treatment, survival rate, and outcome improvement between both conditions. (Trial registration ZU-IRB#:4142/26–12-2017 Registered 26 December 2017, email: IRB_123@medicine.zu.edu.eg).

show abstract

Section: Discussionmentioning

confidence: 99%

Early right ventricular dysfunction after primary percutaneous coronary intervention in anterior versus isolated inferior myocardial infarction assessed by tissue Doppler imaging and speckle tracking echocardiography

Radwan

Alhoseeny²,

Ghoniem³

et al. 2022

Heart Fail Rev

View full text Add to dashboard Cite

show abstract

“…This study did not show an additional risk of hypertension in hospital complications following acute MI in patients with diabetes [9][10] . It showed no interaction between hypertension and diabetes mellitus in terms of complications in acute MI 11 . In line with published international data.…”

Section: Discussionmentioning

confidence: 88%

A Comparative Study of in hospital Complications among Diabetic Hypertensive Patients and Normal Blood Pressure Diabetic Patients Presented with Acute Myocardial Infarction

Akhtar¹,

Ishaq²,

Raza³

et al. 2021

PJMHS

View full text Add to dashboard Cite

Aim: To compare the incidence of in-hospital complications between diabetic normotensive and hypertensive diabetic patients presenting with acute myocardial infarction (MI) Methodology: This observational cohort study was conducted at National Institute of Cardiovascular Diseases Karachi from May 2019 to April 2020. We examined 220 diabetics with acute MI were included. 50% of the patients had high blood pressure and the rest had normal blood pressure. After enrollment in the study, selectees were observed for acute myocardial infarction complications in the hospital. Results: Most of the baseline characteristics were similar in both groups of patients. However, the hypertensive patients in the diabetes group had diabetes, high heart rate, and high blood pressure at reporting. The complication rates did not differ statistically between the two groups. The rates of complications occurred between diabetes and normotensive hypertension; Atrial fibrillation (AF) 15.5% vs 12.7% p = 0.194, respectively, ventricular tachycardia (LH) 14.5% vs 13.6%, AV block type-1 8.2% vs 7.3% p = 0.296, type2 AV block 2.7% vs 1.8% p = 0.352, complete heart block 11.8% vs 10% p = 0.313, acute congestive heart failure (CHF) 13.6% VS% 9.1 p = 0.137, left ventricular failure (LVF)19.1% vs 16.4% p = 0.259, cardiogenic shock (CS) 14.5% vs 10.9% p = 0.184, recurrent IM (Re-MI) 14.5% 10.9% p = 0.184 and mortality 14.5% vs 12.7 and% p = 0.326, respectively. Conclusion:It is concluded that diabetic patients with hypertensionhave not elevated risk of complications in the hospital after acute myocardial infarction. Key words: diabetes, hypertension, hospital complications, acute myocardial infarction

show abstract

“…6 S’ was used in three studies, with two using a cut-off of <15 cm/s 4,8 and one using <10 cm/s. 38 RV longitudinal strain was used in two studies (one study defined RVD as < -20.5% 41 and the other as < -19% 37 ). Other parameters used in single studies included RV size, RV/LV ratio, the presence of RV free wall hypokinesia, and the combination of a raised tricuspid regurgitant velocity (>2.7 m/s) and a shortened pulmonary artery acceleration time (<80 ms).…”

Section: Resultsmentioning

confidence: 99%

“…The isolated delayed mortality subgroup (7 studies, 8,31,35,36,37,38,42 n = 1029 excluding in hospital/prior to day 30 deaths) also demonstrated an increased risk of death with an OR 2.01 (95% CI 1.05-3.86, moderate heterogeneity Higgins I 2 46.8%) compared to the combined control group (figure 4B).…”

Section: Right Ventricular Dysfunction and Mortalitymentioning

confidence: 95%

“…Five studies were multi-centre 6,[30][31][32][33] and the remainder single centre. 12 studies were prospective, 4,6,31,[33][34][35][36][37][38][39][40][41] one included both retrospective and prospective data, 30 and the remaining three were retrospective. 8,32,42 The publication time frame was from 2002 to 2022, although historical patient cohorts for the retrospective studies dated back to 1992.…”

Section: Baseline Characteristics and Study Selectionmentioning

confidence: 99%

See 1 more Smart Citation

Right Ventricular Dysfunction on Transthoracic Echocardiography and Long-Term Mortality in the Critically Unwell: A Systematic Review and Meta-Analysis

Gerhardy,

Sivapathan,

Bowcock

et al. 2023

J Intensive Care Med

View full text Add to dashboard Cite

Objective Right ventricular dysfunction (RVD) is common in the critically ill. To date studies exploring RVD sequelae have had heterogenous definitions and diagnostic methods, with limited follow-up. Additionally much literature has been pathology specific, limiting applicability to the general critically unwell patient. Method and Study Design We conducted a systematic review and meta-analysis to evaluate the impact of RVD diagnosed with transthoracic echocardiography (TTE) on long-term mortality in unselected critically unwell patients compared to those without RVD. A systematic search of EMBASE, Medline and Cochrane was performed from inception to March 2022. All RVD definitions using TTE were included. Patients were those admitted to a critical or intensive care unit, irrespective of disease processes. Long-term mortality was defined as all-cause mortality occurring at least 30 days after hospital admission. A priori subgroup analyses included disease specific and delayed mortality (death after hospital discharge/after the 30th day from hospital admission) in patients with RVD. A random effects model analysis was performed with the Dersimionian and Laird inverse variance method to generate effect estimates. Results Of 5985 studies, 123 underwent full text review with 16 included (n = 3196). 1258 patients had RVD. 19 unique RVD criteria were identified. The odds ratio (OR) for long term mortality with RVD was 2.92 (95% CI 1.92–4.54, I2 76.4%) compared to no RVD. The direction and extent was similar for cardiac and COVID19 subgroups. Isolated RVD showed an increased risk of delayed mortality when compared to isolated left/biventricular dysfunction (OR 2.01, 95% CI 1.05–3.86, I2 46.8%). Conclusion RVD, irrespective of cause, is associated with increased long term mortality in the critically ill. Future studies should be aimed at understanding the pathophysiological mechanisms by which this occurs. Commonly used echocardiographic definitions of RVD show significant heterogeneity across studies, which contributes to uncertainty within this dataset.

show abstract

Subtle Right Ventricular Affection in Patients with Acute Myocardial Infarction, Echocardiographic Assessment

Cited by 4 publications

References 17 publications

Early right ventricular dysfunction after primary percutaneous coronary intervention in anterior versus isolated inferior myocardial infarction assessed by tissue Doppler imaging and speckle tracking echocardiography

Early right ventricular dysfunction after primary percutaneous coronary intervention in anterior versus isolated inferior myocardial infarction assessed by tissue Doppler imaging and speckle tracking echocardiography

A Comparative Study of in hospital Complications among Diabetic Hypertensive Patients and Normal Blood Pressure Diabetic Patients Presented with Acute Myocardial Infarction

Right Ventricular Dysfunction on Transthoracic Echocardiography and Long-Term Mortality in the Critically Unwell: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About