Twenty-four male patients with myocardial infarction (MI) without clinical and electro cardiographic signs of right ventricular (RV) involvement were selected to enter the study. All the patients were divided into two groups: Group I consisted of 12 patients with anterior MI and infarct-related left anterior descending artery and Group II included 12 patients with inferior MI and infarct-related right coronary artery. Patients of Group II had higher right atrial pressure and right atrial pressure/pulmonary capillary wedge pressure ratio (p < 0.01, p < 0.01) and lower values of pulmonary flow velocity, mean acceleration, and pulmonary flow velocity 2/acceleration time ratio than patients of Group I (p < 0.01, p < 0.01, p < 0.01, respectively). Pulmonary flow indices correlated inversely and significantly with hemodynamic dysfunction in patients with inferior myocardial infarction and right coronary proximal lesions (p < 0.01).
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References
1.
Isner JM, Roberts WC: Right ventricular infarction complicating left ventricular infarction secondary to coronary artery disease: Frequency, location, associated findings, and significance from analysis of 256 necropsy patients with acute or healed myocardial infarction. Am J Cardiol42:885-894, 1978.
2.
Ratliff NB, Hackel DB: Combined right and left ventricular infarction: Pathogenesis and clinicopathologic correlations. Am J Cardiol45:217-221, 1980.
3.
Zehender M., Kasper W., Kauder E., et al: Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med328:981-988, 1933.
4.
Robalino BD, Whitlow PL, Underwood DA, et al: Electrocardiographic manifestations of right ventricular infarction . Am Heart J118:138-144, 1989.
5.
D'Arcy B., Nanda NC: Two-dimensional echocardiographic features of right ventricular infarction . Circulation65:167-173, 1982.
6.
Wackers FJ, Lie KI, Sokole EB, et al: Prevalence of right ventricular involvement in inferior wall infarction assessed with myocardial imaging with thallium-201 and technetium 99m pyrophosphate. Am J Cardiol42:358-362, 1978.
7.
Mattioli AV, Bastia E., Mattioli G.: Doppler echocardiographic findings in patients with right ventricular infarction . J Ultrasound Med17:297-301, 1998.
8.
Lopez-Sendon J., Coma-Canella I., Gamallo C.: Sensitivity and specificity of hemodynamic criteria in the diagnosis of acute right ventricular infarction . Circulation64:515-525, 1981.
9.
Lopez-Sendon J., Garcia-Fernandez MA, Coma-Canella I., et al: Segmental right ventricular function after acute myocardial infarction: Two-dimensional echocardiographic study in 63 patients. Am J Cardiol51:390-396, 1983.
10.
Mehta H., Bennet D.: Impaired left ventricular function in acute myocardial infarction assessed by Doppler measurement of ascending blood velocity and maximum acceleration . Am J Cardiol57:1052-1058, 1986 .
11.
Hunt AC, Chow SC, Escaned J., et al: Changes in Doppler indices of cardiac function during and after percutaneous transluminal coronary angioplasty. Br Heart J66:346-350, 1991.
12.
Mehta N., Bennet D., Mannering D., et al: Usefulness of noninvasive Doppler measurement of ascending aortic blood velocity and acceleration in detecting impairment of the left ventricular functional response to exercise three weeks after acute myocardial infarctionAm J Cardiol58:879-884, 1986.
13.
Katayama H. , Henry GW, Krzeski R., et al: Pulmonary blood flow profiles with reduced right ventricular function in lambs. Heart Vessels11:57-63, 1996.
14.
Kennedy J., Trenholme S., Kasser I.: Left ventricular volume and mass from single-plane cineangiogram. A comparison of anteroposterior and anterior oblique methods. Am Heart J80:343-347, 1970.
15.
Bryg R., Labovitz A., Mehdirad A., et al: Effect of coronary artery disease on Doppler-derived parameters of aortic flow during up-right exercise. Am J Cardiol58:14-19, 1986.
16.
Cohen A., Guyon P., Johnson N., et al: Hemodynamic criteria for diagnosis of right ventricular ischemia associated with inferior wall left ventricular acute myocardial infarction . Am J Cardiol76:220-225, 1995.
17.
Coma-Canella I., Lopez Sendon J., Gamallo C., et al: Hemodynamic findings in experimental right ventricular ischemia after right coronary arterial ligation. Eur Heart J7:711-718, 1986.
18.
Hatle LK, Appleton CP, Popp R.: Differentiation of constrictive pericarditis and restrictive cardiomyopathy by Doppler echocardiography. Circulation79:357-370, 1989.
19.
Kitabatake A., Inoue M., Asao M., et al: Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique. Circulation68:302-309, 1983.
20.
Currie PJ, Seward JB, Chan KL, et al: Continuous wave Doppler determination of right ventricular pressure : A simultaneous Doppler catheterization study in 127 patients. J Am Coll Cardiol6:750-756, 1985.
21.
Ferrario M. , Poli A., Previtali M., et al: Hemodynamics of volume loading compared with dobutamine in severe right ventricular infarction. Am J Cardiol74:329-333, 1994.
22.
Santamore WP , Dell'Italia LJ: Ventricular interdependence : Significant left ventricular contributions to right ventricular systolic function . Prog Cardiovasc Dis40:289-308, 1998.
23.
Arditti A.Lewin RF, Hellman C., et al: Right ventricular dysfunction in acute inferoposterior myocardial infarction. An echocardiographic and isotopic study. Chest87:307-314, 1985.
24.
Panidis IP, Ren JF, Kotler MN, et al: Two-dimensional echocardiographic estimation of right ventricular ejection fraction in patients with coronary artery disease. J Am Coll Cardiol2:911-918, 1983.
25.
Shinomiya H. , Fukuda N., Takeichi N., et al: Echocardiographic assessment of right atrial function in patients with myocardial infarction with reference to obstructive lesions of the coronary arteries. Jpn Circ J62:393-398, 1998.
