Angiographic result of index PCI determines the presence of right ventricular infarction in patients with acute inferior myocardial infarction

作者：Tomala Marek^*; Miszalski Jamka Tomasz; Zajdel Wojciech; Nawrotek Bartlomiej; Mazur Wojciech; Kereiakes Dean J; Zmudka Krzysztof

来源：International Journal of Cardiovascular Imaging, 2015, 31(8): 1591-1601.

DOI：10.1007/s10554-015-0717-8

• Acute myocardial infarction
• Cardiac magnetic resonance imaging
• Right ventricle infarction
• Primary percutaneous coronary intervention

It is still a matter of debate which patients with acute inferior myocardial infarction are at increased risk of developing right ventricular (RV) myocardial infarction (RVMI). Cardiac magnetic resonance imaging (CMRI) with late enchancement (LE) is regarded as the gold standard for RVMI assessment. We aimed to determine the impact of initial angiographic status and salutary effect of primary percutaneous coronary intervention (PCI) on the presence of RVMI. In 114 patients undergoing emergency angiography and primary PCI of right coronary artery, 3-5 days after index PCI, LE CMRI was performed for assessing the RVMI. Forty-eight patients (42 %) demonstrated RVMI. Multivariate regression analysis identified TIMI flow < 2 in at least one RV branch after PCI as an independent angiographic predictor of RVMI [odds ratio (OR) 143.00, 95 % confidence interval (CI) 18.10-1130.05, p < 0.001]. ST-segment elevation a parts per thousand yen1 mm in V4R was present in 83 (73 %). TIMI flow < 3 in at least one RV branch before PCI (OR 4.07, 95 % CI 1.24-13.33, p = 0.02) was independent angiographic predictor of ST-segment elevation a parts per thousand yen1 mm in V4R. The only predictor of RVMI was TIMI flow < 2 in at least one RV branch after PCI. ST-segment elevation a parts per thousand yen1 mm in V4R is caused by TIMI < 3 flow in at least one RV branch before index PCI.

• 出版日期2015-12