Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Circ Cardiovasc Imaging. 2010 May;3(3):264-71. doi: 10.1161/CIRCIMAGING.109.914366. Epub 2010 Feb 27.
Data on the association between right ventricular (RV) function and adverse events after acute myocardial infarction (AMI) are scarce. The purpose of the current study was to evaluate the relation between RV function and adverse events in patients treated with primary percutaneous coronary intervention for AMI.
Consecutive patients admitted with AMI treated with primary percutaneous coronary intervention underwent echocardiography within 48 hours of admission to assess left ventricular and RV function. RV function was quantified with RV fractional area change (RVFAC), tricuspid annular plane systolic excursion, and RV strain. The end point was defined as a composite of all-cause mortality, reinfarction, and hospitalization for heart failure. All patients (n=621) were followed prospectively, and during a mean follow-up of 24 months, 86 patients reached the composite end point. RVFAC, tricuspid annular plane systolic excursion, and RV strain were all univariable predictors of worse outcome. After multivariable analysis, only RVFAC (hazard ratio, 0.96; 95% CI, 0.92 to 0.99) and RV strain (hazard ratio, 1.08; 95% CI, 1.03 to 1.13) independently predicted the composite end point. In addition, RV strain provided incremental value to clinical information, infarct characteristics, left ventricular function, and RVFAC.
RV function provides strong prognostic information in patients treated with primary percutaneous coronary intervention for AMI.
关于右心室（RV）功能与急性心肌梗死（AMI）后不良事件之间的关系的数据很少。本研究的目的是评估在接受经皮冠状动脉介入治疗的 AMI 患者中 RV 功能与不良事件之间的关系。
连续因 AMI 入院并接受经皮冠状动脉介入治疗的患者在入院后 48 小时内接受超声心动图检查以评估左心室和 RV 功能。RV 功能用 RV 节段面积变化（RVFAC）、三尖瓣环平面收缩期位移和 RV 应变来量化。终点定义为全因死亡率、再梗死和因心力衰竭住院的复合终点。所有患者（n=621）均进行前瞻性随访，平均随访 24 个月期间，86 例患者达到复合终点。RVFAC、三尖瓣环平面收缩期位移和 RV 应变均为单变量不良预后预测因子。多变量分析后，仅 RVFAC（危险比，0.96；95%可信区间，0.92 至 0.99）和 RV 应变（危险比，1.08；95%可信区间，1.03 至 1.13）独立预测复合终点。此外，RV 应变提供了对临床信息、梗塞特征、左心室功能和 RVFAC 的增量价值。
RV 功能为接受经皮冠状动脉介入治疗的 AMI 患者提供了强有力的预后信息。
