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Minerva Cardioangiologica 2020 Jul 10

DOI: 10.23736/S0026-4725.20.05223-8


language: English

Comparison of myocardial tissue-reperfusion of inferior wall and a right ventricle among patients after primary angioplasty for an inferior myocardial infarction with right ventricular infarction

Michał ŚWIERCZEWSKI 1 , Edyta KACZMARSKA 2, Rajmund BOBROWSKI 2, Kamil ZIELIŃSKI 1, Jerzy PRĘGOWSKI 2, Bożena NORWA-OTTO 2, Michał CISZEWSKI 2, Maciej DĄBROWSKI 2, Zbigniew CHMIELAK 2, Marcin DEMKOW 2, Adam WITKOWSKI 2, Łukasz KALIŃCZUK 2, Witold RUŻYŁŁO 2

1 Medical University of Warsaw, Warsaw, Poland; 2 Institute of Cardiology, Warsaw, Poland


BACKGROUND: Impaired myocardial tissue reperfusion affects prognosis of patients with ST- segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) and can be identified by ST-segment analysis. To date, evaluation of the myocardial tissue reperfusion of the right ventricle (RV) among the patients treated with PCI for inferior STEMI with right ventricular infarction (RVI) has not been made yet.
METHODS: Patients with inferior STEMI were screened for RVI. Tissue reperfusion was evaluated by maximal residual ST-segment deviation post PCI, independently for the RV and for inferior wall. Myocardial injury was assessed by the peak creatine kinase-mb (CK-MB) value.
RESULTS: Among 456 patients with inferior STEMI, concomitant RVI occurred in 153 (33.5%) subjects (59.86 ± 10.35 years old, 71.9% ♀). Tissue reperfusion of LV was present in 75 (49%), whereas 55 (35.9%) had both successful LV and RV reperfusion. Among 97 (63.4%) with successful tissue reperfusion of RV, 55 (56.7%) had associated successful tissue reperfusion of inferior wall. Adequate LV reperfusion was accompanied by RV in over 73.3% of patients (p = 0.006). Mean peak CK-MB was lower in the group with adequate versus impaired RV tissue-perfusion (197 ± 143 vs 305 ± 199 U/L, p = 0.021 respectively).
CONCLUSIONS: Impaired reperfusion of RV is observed in more than one third of inferior STEMIs with RVI, and is not strictly associated with impaired reperfusion of inferior wall and also clinical or angiographic variables, therefore ST-segment analysis for RV is mandatory.

KEY WORDS: Right ventricular infarction; Inferior STEMI; Myocardial tissue reperfusion; Primary percutaneous angioplasty

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