Right ventricular function in patients presenting with non-ST-segment elevation myocardial infarction undergoing an invasive approach

• Main Authors: Ahmed Shawky Elserafy, Ahmed Nabil, Ali Ali Ramzy, Mohamed Abdelmenem
• Format: Article
• Language: English
• Published: SpringerOpen 2018-09-01
• Series: The Egyptian Heart Journal
• Online Access: http://www.sciencedirect.com/science/article/pii/S111026081830022X

Background: Right ventricular involvement in ST segment elevation myocardial infarction (STEMI) entails an increased morbidity and mortality. However, very scarce data is present on its affection in the setting of non-ST segment elevation myocardial infarction (NSTEMI). Aim: To assess the affection of right ventricular function in patients presenting with NSTEMI undergoing an invasive procedure. Subjects and methods: One hundred and fifty patients admitted with a first NSTEMI and eligible for reperfusion therapy via invasive percutaneous coronary intervention. These patients were divided in two groups; group A including patients with normal RV function, and group B including patients with impaired RV function as diagnosed by tricuspid annular plane systolic excursion (TAPSE) cutoff value < 17 mm. All patients underwent angioplasty and were followed up in-hospital and for 3 months. Results: RV dysfunction occurred in ninety-five (61.3%) patients of the study population. Significant improvement occurred to TAPSE after 3 months in comparison to TAPSE at baseline (15.45 ± 3.21 versus 17.09 ± 4.17 mm). Those with impaired RV function showed improvement of TAPSE after three months as compared to baseline (13.62 ± 2.58 vs 17.16 ± 3.64 p = 0.008). Multivariate analysis determined the independent predictors of RV dysfunction as RVEDD > 26 mm, RVFAC < 35%, RAA > 20 cm2, and TAPSE < 17 mm. Conclusion: RV dysfunction is not uncommon in NSTEMI when using the definition of TAPSE < 17 mm. Following up RV function by TAPSE, showed significant improvement after 3 months with successful PCI as compared to baseline. We recommend assessing and following up RV function in all patients admitted with a NSTEMI. Keywords: NSTEMI, Invasive therapy, Right ventricular function