PMID- 26960201
OWN - NLM
STAT- MEDLINE
DCOM- 20170327
LR  - 20170817
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 27
IP  - 4
DP  - 2016 Jun
TI  - Left ventricular systolic dysfunction is associated with adverse outcomes in 
      acute right ventricular infarction.
PG  - 277-86
LID - 10.1097/MCA.0000000000000358 [doi]
AB  - BACKGROUND: In patients with acute right ventricular infarction (RVI), global 
      right ventricular (RV) performance is dependent on compensatory left ventricular 
      (LV)-septal contractile contributions. This study was designed to assess the 
      influence of depressed left ventricular ejection fraction (LVEF) on hemodynamics 
      and clinical outcomes in patients with RVI. METHODS AND RESULTS: We 
      retrospectively identified 338 patients with acute inferior ST elevation 
      myocardial infarction (STEMI) undergoing a primary percutaneous coronary 
      intervention. RVI was determined echocardiographically by right ventricular free 
      wall motion abnormalities and depressed global RV performance (fractional area 
      change); LV function was similarly calculated. RVI was documented in 185 (55%) 
      cases. Compared with those with inferior myocardial infarction alone, patients 
      with RVI suffered more hemodynamic compromise (need for inotropes or vasopressors 
      39 vs. 15%, P<0.0001, and intra-aortic balloon pump 32 vs. 13%, P<0.0001) and 
      higher in-hospital mortality (14 vs. 3%, P=0.0006). In cases without RVI, the 
      status of LV function did not influence in-hospital mortality (ejection 
      fraction</=40%=7.3% vs. ejection fraction>40%=1.8, P=0.12). In contrast, in 
      patients with RVI, LVEF was an important determinant of outcome: those with LVEF 
      </= 40% suffered more hemodynamic compromise (need for inotropes or vasopressors 63 
      vs. 30%, P<0.0001, and intra-aortic balloon pump 59 vs. 22%, P<0.0001) and had 
      markedly higher in-hospital mortality (33 vs. 7%, P<0.0001). CONCLUSION: In 
      patients with acute inferior myocardial infarction complicated by RVI, depressed 
      LVEF is associated with greater hemodynamic compromise and higher in-hospital 
      mortality. These findings may have clinical implications for supportive efforts 
      in such cases.
FAU - Goldstein, James A
AU  - Goldstein JA
AD  - aDepartment of Cardiovascular Medicine, Beaumont Health System, Royal Oak bHurley 
      Medical System, Flint, Michigan, USA.
FAU - Kommuri, Naga
AU  - Kommuri N
FAU - Dixon, Simon R
AU  - Dixon SR
LA  - eng
PT  - Journal Article
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Vasoconstrictor Agents)
SB  - IM
MH  - Aged
MH  - Cardiotonic Agents/therapeutic use
MH  - Databases, Factual
MH  - Echocardiography
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Inferior Wall Myocardial Infarction/diagnostic 
      imaging/mortality/*physiopathology/therapy
MH  - Intra-Aortic Balloon Pumping
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnostic 
      imaging/mortality/*physiopathology/therapy
MH  - Stroke Volume
MH  - Systole
MH  - Treatment Outcome
MH  - Vasoconstrictor Agents/therapeutic use
MH  - Ventricular Dysfunction, Left/diagnostic 
      imaging/mortality/*physiopathology/therapy
MH  - Ventricular Dysfunction, Right/diagnostic 
      imaging/mortality/*physiopathology/therapy
MH  - *Ventricular Function, Left/drug effects
MH  - *Ventricular Function, Right/drug effects
EDAT- 2016/03/10 06:00
MHDA- 2017/03/28 06:00
CRDT- 2016/03/10 06:00
PHST- 2016/03/10 06:00 [entrez]
PHST- 2016/03/10 06:00 [pubmed]
PHST- 2017/03/28 06:00 [medline]
AID - 10.1097/MCA.0000000000000358 [doi]
PST - ppublish
SO  - Coron Artery Dis. 2016 Jun;27(4):277-86. doi: 10.1097/MCA.0000000000000358.