Niels Risum1, Nana Valeur2, Peter Søgaard3, Christian Hassager1, Lars Køber1, Mads Ersbøll1. 1. Department of Cardiology, Rigshospitalet Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. 2. Department of Cardiology, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. 3. Department of Cardiology, Clinical Institute, Aalborg University Hospital, Aalborg, Hobrovej 18-22, Aalborg 9000, Denmark.
Abstract
Aims: Left ventricular function is a well-established predictor of malignant ventricular arrhythmias, but little is known about the importance of right ventricular (RV) function. The aim of this study was to investigate the importance of RV function for prediction of sudden cardiac death (SCD) or malignant ventricular arrhythmias (VAs) after acute myocardial infarction (MI). Methods and results: A total of 790 patients with acute MI were prospectively included. All patients had 2D strain echocardiography performed to evaluate right ventricular (RV) free wall strain (RVS) and RV mechanical dispersion (MD) defined as the standard deviation of time to peak negative strain in all myocardial segments. The primary composite end point [SCD, admission with VA or appropriate therapy from a primary prophylactic implantable cardioverter-defibrillator (ICD)] was analysed with Cox models. Mean age was 69 ± 12 years, and 74% were male. Thirty-one patients experienced the primary end point during a median follow-up of 898 days (Q1-Q3 704-981). RVS was independently associated with outcome in a multivariable model including age and left ventricular global longitudinal strain; pr 1% change [hazard ratio (HR) 1.08, 95% confidence interval (CI) 1.01-1.15; P = 0.038]. Patients in the lower tertile (poor strain) showed a 10-fold risk of an event compared with the upper tertile (HR 9.8, 95% CI 2.23-42.3; P = 0.002). RV MD was not independently associated with VA/SCD (HR 0.99, 95% CI 0.91-1.09; P = 0.93). RVS proved superior to tricuspid annular plane systolic excursion (TAPSE) (P = 0.03) in the multivariable model. Conclusion: RVS, but not RV MD, was significantly and independently related to SCD/VA in patients with acute MI. Furthermore, RVS was shown to be superior to TAPSE.
Aims: Left ventricular function is a well-established predictor of malignant ventricular arrhythmias, but little is known about the importance of right ventricular (RV) function. The aim of this study was to investigate the importance of RV function for prediction of sudden cardiac death (SCD) or malignant ventricular arrhythmias (VAs) after acute myocardial infarction (MI). Methods and results: A total of 790 patients with acute MI were prospectively included. All patients had 2D strain echocardiography performed to evaluate right ventricular (RV) free wall strain (RVS) and RV mechanical dispersion (MD) defined as the standard deviation of time to peak negative strain in all myocardial segments. The primary composite end point [SCD, admission with VA or appropriate therapy from a primary prophylactic implantable cardioverter-defibrillator (ICD)] was analysed with Cox models. Mean age was 69 ± 12 years, and 74% were male. Thirty-one patients experienced the primary end point during a median follow-up of 898 days (Q1-Q3 704-981). RVS was independently associated with outcome in a multivariable model including age and left ventricular global longitudinal strain; pr 1% change [hazard ratio (HR) 1.08, 95% confidence interval (CI) 1.01-1.15; P = 0.038]. Patients in the lower tertile (poor strain) showed a 10-fold risk of an event compared with the upper tertile (HR 9.8, 95% CI 2.23-42.3; P = 0.002). RV MD was not independently associated with VA/SCD (HR 0.99, 95% CI 0.91-1.09; P = 0.93). RVS proved superior to tricuspid annular plane systolic excursion (TAPSE) (P = 0.03) in the multivariable model. Conclusion: RVS, but not RV MD, was significantly and independently related to SCD/VA in patients with acute MI. Furthermore, RVS was shown to be superior to TAPSE.
Authors: A Malagoli; A Albini; G E Mandoli; A Baggiano; G Vinco; F Bandera; A D'Andrea; R Esposito; F D'Ascenzi; R Sorrentino; C Santoro; G Benfari; F Contorni; M Cameli Journal: Int J Cardiovasc Imaging Date: 2021-06-10 Impact factor: 2.357
Authors: Giuseppe Muscogiuri; Andrea Igoren Guaricci; Nicola Soldato; Riccardo Cau; Luca Saba; Paola Siena; Maria Grazia Tarsitano; Elisa Giannetta; Davide Sala; Paolo Sganzerla; Marco Gatti; Riccardo Faletti; Alberto Senatieri; Gregorio Chierchia; Gianluca Pontone; Paolo Marra; Mark G Rabbat; Sandro Sironi Journal: J Clin Med Date: 2022-09-26 Impact factor: 4.964