PREDICTIVE ROLE OF INFARCT RELATED ARTERY IN ACUTE RIGHT VENTRICULAR INFARCTION DIAGNOSED USING ELECTROCARDIOGRAPHY
Journal
Journal of Morphological Sciences
Date Issued
2022
Author(s)
Zafirovska, Planinka
DOI
10.55302/jms225301a
Abstract
Right coronary artery (RCA) emerged as an infarct-related artery (IRA) in patients with right
ventricular myocardial infarction (RVMI), which is followed by some degree of RV dysfunction. The
aim of our study was to identify significant predictors of IRA among angiographic and/or
echocardiographic data of RV dimension and/or function in patients with acute RVMI.
Out of 122 hospitalized patients with acute inferior myocardial infarction, on the basis of
electrocardiographic (ECG) criteria, RVMI was diagnosed in 58/47.5% of patients. Coronary
angiography was applied in 52/89,6% immediately after admission and conventional 2D
echocardiography was performed in order to assess right heart dimensions and function according to the
professional association recommendations.
RCA emerged as IRA in 49/84,5 % of patients with ECG-diagnosed RVMI. Patients with RCA
stenosis/occlusion had 4.9 times higher risk for RVMI presence (OR=4.941; 95%CI: 1.727-14.136;
p=0.003) than those without and had significantly worse echocardiographic assessed RV global and/or
regional systolic function. Logistic stepwise regression analysis confirmed the significant role of
enlarged RV dimension (OR=1.1; 95%CI: 1.023-1.182; p=0.010), RCA stenosis/occlusion presence
(OR=4.8; 95%CI: 1.649-14.199; p=0.004) and/or LAD stenosis/occlusion absence (OR=0.18; 95%CI:
0.067-0.476; p=0.001) in the prediction of RVMI. The optimal sensitivity of the model was 90% and
the specificity was 75%.
RCA and conversely lack of LAD stenosis/occlusion presence along with some of the
echocardiographic parameters showing RV dysfunction increased the odds for RVMI. Applying
immediate and complete reperfusion of RCA is of great importance for the recovery of RV function.
ventricular myocardial infarction (RVMI), which is followed by some degree of RV dysfunction. The
aim of our study was to identify significant predictors of IRA among angiographic and/or
echocardiographic data of RV dimension and/or function in patients with acute RVMI.
Out of 122 hospitalized patients with acute inferior myocardial infarction, on the basis of
electrocardiographic (ECG) criteria, RVMI was diagnosed in 58/47.5% of patients. Coronary
angiography was applied in 52/89,6% immediately after admission and conventional 2D
echocardiography was performed in order to assess right heart dimensions and function according to the
professional association recommendations.
RCA emerged as IRA in 49/84,5 % of patients with ECG-diagnosed RVMI. Patients with RCA
stenosis/occlusion had 4.9 times higher risk for RVMI presence (OR=4.941; 95%CI: 1.727-14.136;
p=0.003) than those without and had significantly worse echocardiographic assessed RV global and/or
regional systolic function. Logistic stepwise regression analysis confirmed the significant role of
enlarged RV dimension (OR=1.1; 95%CI: 1.023-1.182; p=0.010), RCA stenosis/occlusion presence
(OR=4.8; 95%CI: 1.649-14.199; p=0.004) and/or LAD stenosis/occlusion absence (OR=0.18; 95%CI:
0.067-0.476; p=0.001) in the prediction of RVMI. The optimal sensitivity of the model was 90% and
the specificity was 75%.
RCA and conversely lack of LAD stenosis/occlusion presence along with some of the
echocardiographic parameters showing RV dysfunction increased the odds for RVMI. Applying
immediate and complete reperfusion of RCA is of great importance for the recovery of RV function.
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