TITLE:
Impact of Right Ventricular Dysfunction in Morbidity and Mortality in Patients with Inferior Wall Myocardial Infarction Presenting to a Tertiary Care Center of Nepal
AUTHORS:
Abhishesh Shakya, Ratnamani Gajurel, Chandramani Poudel, Anish Baniya, Ravi Sahi
KEYWORDS:
Anterior Wall Myocardial Infarction, Inferior Wall Myocardial Infarction, Right Ventricular Infarction, Prognosis
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.11,
November
24,
2023
ABSTRACT: Introduction: In comparison to anterior wall myocardial
infarction, inferior wall myocardial infarction is generally regarded as a low
risk event. The aim of this study was to evaluate the prognostic impact of
right ventricular (RV) myocardial involvement in patients with inferior wall
myocardial infarction (IWMI). Methods: This is an observational study of
82 consecutive IWMI patients admitted and treated in Manmohan Cardiothoracic,
Vascular and Transplant Center (MCVTC) from May 15 2018 to June 15 2019. The
clinical characteristics, risk factors profile, electrocardiographic,
echocardiographic, including RV function and angiographic characteristics,
complications and in-hospital deaths were analyzed. Results: The mean
age of patients presenting with IMWI was 64.8 ± 13.8 years with predominance of
male (67%). Right ventricular myocardial infarction was present in 34.1% of
patient with RV dysfunction in 25.6% patients. Mean Tricuspid Annular Plane
Systolic Excursion (TAPSE), RV tricuspid annulus (S') and RV Fractional area change (FAC) in patients
with RV dysfunction vs patients without RV dysfunction were 12.2 ± 3.3 mm vs
22.5 ± 3.5 mm (p 2 vs 39.46 ± 2.85 mm2 respectively (p Conclusion: In inferior wall myocardial infarction, RV involvement with RV dysfunction
is an independent risk factor for in-hospital mortality along with advanced
age, complete atrioventricular block, higher Killip class, delayed hospital
presentation, left ventricular ejection fraction