Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Left ventricular remodeling in patients with right ventricular myocardial infarction

https://doi.org/10.20996/1819-6446-2015-11-6-595-600

Full Text:

Abstract

Aim. To study left ventricular (LV) remodeling, interventricular and intraventricular asynchrony in isolated inferior LV myocardial infarction (MI) or combined inferior LV MI with right ventricular (RV) MI.

Material and methods. 57 patients with inferior LV MI with or without RV MI (n=57) were included in a 6-month prospective study. The patients were divided into 2 groups: Group 1 - patients with inferior LV MI (n=30); Group 2 - patients with inferior LV MI in combination with RV MI (n=27). Electrocardiography and echocardiography were performed in all patients at admission, on days 3, 30 and 180 after MI.

Results. Significant signs of diastolic dysfunction (RV end-diastolic area 29.21±2.0 cm2) were found in group 2 on the third day after MI. A significant increase in the LV volume indices and diastolic sphericity index (from 0.54±0.02 to 0.59±0.03 units) and an increase in interventricular asynchrony (from 37.4±4.2 to 44.6±4.2 ms) were found in group 2 in 30 days after MI. Increasing tendency towards intraventricular and interventricular asynchrony, despite the absence of pathological LV remodeling, occurred in group 2 in 6 
months after MI.

Conclusion. Patients with RV MI have more pronounced maladaptive LV remodeling, intraventricular and interventricular asynchrony and greater LV diastolic dysfunction.

About the Authors

M. T. Beyshenkulov,
National Center of Cardiology and Therapy named after Academician M.M. Mirrahimov Togoloka Moldo ul. 3, Bishkek, 720040 Kyrgyzstan
Russian Federation


Z. M. Chazymova
National Center of Cardiology and Therapy named after Academician M.M. Mirrahimov Togoloka Moldo ul. 3, Bishkek, 720040 Kyrgyzstan
Russian Federation


A. S. Abylgazieva
National Center of Cardiology and Therapy named after Academician M.M. Mirrahimov Togoloka Moldo ul. 3, Bishkek, 720040 Kyrgyzstan
Russian Federation


K. R. Kaliev
National Center of Cardiology and Therapy named after Academician M.M. Mirrahimov Togoloka Moldo ul. 3, Bishkek, 720040 Kyrgyzstan
Russian Federation


References

1. Chhapra D., Mahajan S., Thorat S. A study of the clinical profile of right ventricular infarction in context to inferior wall myocardial infarction in a tertiary care centre. J Cardiovasc Dis Res. 2013; 4(3): 170-6.

2. Inohara T., Kohsaka S., Fukuda F. et al. The challenges in the management of right ventricular infarction. Eur Heart J Acute Cardiovasc Care. The challenges in the management of right ventricular infarction. 2013; 2(3): 226-34.

3. Hamon M., Agostini D., Le Page O. et al. Prognostic impact of right ventricular involvement in patients with acute myocardial infarction: meta-analysis. Crit Care Med 2008; 36:2023-33.

4. Russ M., Prondzinsky R., Carter J. et al. Right ventricular function in myocardial infarction complicated by cardiogenic shock: improvement with levosimendan. Crit Care Med. 2009; 37:3017-23.

5. Garza M.A., Wason E.A., Zhang E.Q. Cardiac remodeling and physical training post myocardial infarction. World J Cardiol 2015; 7(2): 52-64.

6. Liszka J., Haberka M., Tabor Z. et al. Two-dimensional speckle-tracking echocardiography assessment of left ventricular remodeling in patients after myocardial infarction and primary reperfusion. Arch Med Sci 2014; 10(6): 1091-100.

7. Zhang X., Cowan B.R., Bluemke D.A. et al. Atlas-based quantification of cardiac remodeling due to myocardial infarction. PLoS One 2014; 9(10): e110243.

8. Eschalier R., Fertin M., Fay R. et al. Extracellular Matrix Turnover Biomarkers Predict Long-Term Left Ventricular Remodeling After Myocardial Infarction. Circ Heart Fail. 2013; 6(6): 1199-205.

9. Joyce E., Hoogslag G.E., Leong D.P. et al. Association Between Left Ventricular Global Longitudinal Strain and Adverse Left Ventricular Dilatation After ST-Segment-Elevation Myocardial Infarction. Circ Cardiovasc Imaging. 2014; 7(1): 74-81.

10. Tan J., Hua Q. Correlations between serum inflammation factors and left ventricular remodeling in acute ST segment elevation myocardial infarction. Yonsei Med J 2012; 53(3): 501-7.

11. Flachskampf F.A., Schmid M., Rost C. et al. Cardiac imaging after myocardial infarction. Eur Heart J. 2011; 32(3): 372-83.

12. Bockeria L.A., Bockeria O.L., Kislitsina O.N. et al. Application method and efficiency value of echocardiography in diagnostics of dissynchronism before and implantation of devices for heart resynchronization. Annali Aritmologii 2010; 3:31-42. In Russian (Бокерия Л.А., Бокерия О.Л., Кислицина О.Н. и др. Методика применения и оценка эффективности использования эхокардиографии в диагностике диссинхронии до и после имплантации устройств ресинхронизации сердца. Анналы аритмологии 2010; 3:31-42).

13. Wildgruber M., Bielicki I., Aichler M. et al. Assessment of myocardial infarction and postinfarction scar remodeling with an elastin-specific magnetic resonance agent. Circ Cardiovasc Imaging. 2014; 7(2): 321-9.

14. Reis Filho J.R., Cardoso J.N., Cardoso C.M. et al. Reverse Cardiac Remodeling: A Marker of Better Prognosis in Heart Failure. Arq Bras Card 2015; 104(6): 502-6.

15. Grothoff M., Elpert C., Hoffmann J. et al. Right ventricular injury in ST-elevation myocardial infarction: risk stratification by visualization of wall motion, edema, and delayed-enhancement cardiac magnetic resonance. Circ Cardiovasc Imaging 2012; 5(1): 60-8.

16. Ramzy I.S., O,Sullivan C.А., Lam Y.Y. et al. Right ventricular stunning in inferior myocardial infarction. Int J Cardiol 2009; 136:294-9.

17. Carville S.F., Henderson R., Gray H. The acute management of ST-segment-elevation myocardial infarction. Clin Med 2015; 15(4): 362-7.

18. Ondrus T., Kanovsky J., Novotny T. et al. Right ventricular myocardial: From pathophysiology to prognosis. Exp Clin Cardiol 2013; 18(1): 27-30.

19. Chanal A.A., Kim M.Y., Borg A.N. et al. Primary angioplasty for infarction due to isolated right ventricular artery occlusion. World J Cardiol 2014; 6(11): 1223-6.

20. Manka R., Fleck E., Paetsch I. Silent inferior myocardial infarction with extensive right ventricular scarring. Int J Cardiol 2008; 127(3): 186-7.

21. Kakouros N., Cokkinos D., Right ventricular myocardial infarction: pathophysiology, diagnosis, and management. Postgrad Med J 2010; 86(1022): 719-28.

22. O’Rourke R.A., Dell’Italia L.J. Diagnosis and management of right ventricular myocardial infarction. Curr Probl Cardiol. 2004; 29(1):6-47.

23. Chockalingam A., Gnanavelu G., Subramaniam T. et al. Right ventricular myocardial infarction: presentation and acute outcomes. Angiology. 2005; 56(4): 371-6.

24. Engstorm A.E., Vis M.M., Bouma B.J. et al. Right ventricular dysfunction is an independent predictor for mortality in ST-elevation myocardial infarction patients presenting with cardiogenic shock on admission. Eur J Heart. 2010; 12(3): 276-82.

25. Hamon M., Agostini D., Le Page O. et al., Prognostic impact of right ventricular involvement in patients with acute myocardial infarction: meta-analysis. Crit Care Med 2008; 36(7): 2023-33.


Review

For citations:


Beyshenkulov, M.T., Chazymova Z.M., Abylgazieva A.S., Kaliev K.R. Left ventricular remodeling in patients with right ventricular myocardial infarction. Rational Pharmacotherapy in Cardiology. 2015;11(6):595-600. (In Russ.) https://doi.org/10.20996/1819-6446-2015-11-6-595-600

Views: 756


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)