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Novo G, Almeida A, Nobile D, Morreale P, Fattouch K, Lisi DD, Manno G, Lancellotti P, Pinto FJ. RIGHT VENTRICLE FUNCTION IN PATIENTS WITH ANTERIOR MYOCARDIAL INFARCTION: ARE WE SURE IT IS NOT INVOLVED? Curr Probl Cardiol 2022; 47:101277. [PMID: 35661811 DOI: 10.1016/j.cpcardiol.2022.101277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
The right and left ventricle of heart are intimately connected by anatomical and functional links. Hence, acute changes in cardiac geometry and function can modify the performance and physiology of both sides of the heart, influencing each other. After a brief overview of the anatomy and related imaging techniques for the study of right ventricular function, we report a review on the interesting correlation of acute anterior myocardial infarction and right ventricular function, very often underestimated.
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Affiliation(s)
- Giuseppina Novo
- Cardiology Unit, Department of Excellence of Sciences for Health Promotion and Mothernal-Child Care, Internal Medicine and Specialities (ProMISE), University of Palermo, University Hospital Paolo Giaccone, Palermo, Italy.
| | - Ana Almeida
- Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria, CHULN, Portugal
| | - Domenico Nobile
- Cardiology Unit, Department of Excellence of Sciences for Health Promotion and Mothernal-Child Care, Internal Medicine and Specialities (ProMISE), University of Palermo, University Hospital Paolo Giaccone, Palermo, Italy
| | - Pierluigi Morreale
- Cardiology Unit, Department of Excellence of Sciences for Health Promotion and Mothernal-Child Care, Internal Medicine and Specialities (ProMISE), University of Palermo, University Hospital Paolo Giaccone, Palermo, Italy
| | - Khalil Fattouch
- Maria Eleonora Hospital, Department of Cardiac Surgery, GVM Care & Research, Palermo, Italy
| | - Daniela Di Lisi
- Cardiology Unit, Department of Excellence of Sciences for Health Promotion and Mothernal-Child Care, Internal Medicine and Specialities (ProMISE), University of Palermo, University Hospital Paolo Giaccone, Palermo, Italy
| | - Girolamo Manno
- Cardiology Unit, Department of Excellence of Sciences for Health Promotion and Mothernal-Child Care, Internal Medicine and Specialities (ProMISE), University of Palermo, University Hospital Paolo Giaccone, Palermo, Italy
| | - Patrizio Lancellotti
- Department of Cardiology, Groupe Interdisciplinaire de Genoproteomique Appliquee Cardiovascular Sciences, University of Liège, Liège, Belgium
| | - Fausto J Pinto
- Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria, CHULN, Portugal
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Myocardial ischemia and its complications. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00022-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Dehghani P, Zahedi A, Hassanzadeh M, Alavi SH, Jannati M, Mehdipour Namdar Z, Aslani A. Significance of ST-Segment elevation in V4R lead in patients with anterior myocardial infarction. Ann Noninvasive Electrocardiol 2021; 26:e12866. [PMID: 34089286 PMCID: PMC8411741 DOI: 10.1111/anec.12866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/06/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background There is some evidence of the association between ST‐segment elevation in the V4R chest lead and the likelihood of anterior wall myocardial infarction; however, the link of this phenomenon with the location and the severity of the coronary involvements in such patients remains uncertain. We aimed to investigate the ST‐segment elevation in V4R leads in patients with anterior myocardial infarction and also its effect on prognosis as well as the detection and prediction of the location of arterial stenosis in coronary angiography. Methods Data collection was performed by reviewing the hospital recorded files of 195 patients’ suspicion of acute myocardial infarction who have been referred within 2 h of the onset of cardiac symptoms. The patients were then categorized into two groups with and without ST elevation in the V4R chest lead. Results Comparing two groups showed a significantly higher rate of concurrent ST‐segment elevation in V1 lead in those with ST‐segment elevation in V4R. Echocardiography on the day after anterior myocardial infarction showed LVEF <40% in 74% and 35.2% of patients with and without ST‐segment elevation in V4R, respectively, indicating a significant difference. The lesions on proximal LAD were more common in the group with ST‐segment elevation in V4R. Conclusion Our study emphasized a high likelihood of ST‐segment elevation in V4R lead concurrently with ST‐elevation in V1 lead. Also, the appearance of ST‐segment elevation in V4R lead can be accompanied with a lower LVEF, myocardial infarct size, involvement of proximal part of LAD, and Wrap around LAD.
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Affiliation(s)
| | - Ali Zahedi
- Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | | | | | - Amir Aslani
- Shiraz University of Medical Sciences, Shiraz, Iran
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Ghaffari S, Taban Sadeghi M, Sayyadi MH. The association of right coronary artery conus branch size and course with ST segment elevation of right precordial leads and clinical outcome of acute anterior myocardial infarction. J Cardiovasc Thorac Res 2017; 9:49-53. [PMID: 28451088 PMCID: PMC5402027 DOI: 10.15171/jcvtr.2017.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/11/2017] [Indexed: 12/25/2022] Open
Abstract
Introduction: Coronary artery disease is the leading cause of death worldwide and electrocardiogram (ECG) is a reliable diagnostic tool to determine a myocardial infarction. The present study tried to compare the relationship between the ECG findings and angiographic findings in patients with acute anterior myocardial infarction. Methods: Seventy-four patients with acute anterior ST elevation myocardial infarction (Ant- STEMI) presenting to the emergency room in the first 12 hours after the onset of symptoms were studied. Upon admission, a full 14-lead ECG (including leads V3R and V4R) were performed. Angiographic and ECG findings, as well as clinical outcome were compared between two groups. The statistical tests including Chi-square and independent t-test were used for data analysis. Results: Small conus branch was seen in 52 (70.3%) and large conus in 22 ( 29.7%) patients. STE in right-sided leads and heart failure were significantly higher in small conus branch group versus large conus branch (88.6% vs 11.4%, P < 0.001 and 34.6% vs 9.1%, P = 0.02 respectively). There was no significant difference in mortality rate between the two groups (5.8% in small conous group vs 0% in large conus group, P = 0.55). There was a significant difference in major adverse cardiac events (MACE) between the two groups (51.9% in small conous group vs 18.2% in large conus group, P = 0.01). Conclusion: In patients with anterior MI, small conus branch was associated with higher rate of major adverse cardiac events mostly because of increased rate of acute heart failure.
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Affiliation(s)
- Samad Ghaffari
- Cardiovascular Research Center, Madani Heart Hospital, Tabriz University of Medicine, Tabriz, Iran
| | | | - Mohammad Hossein Sayyadi
- Cardiovascular Research Center, Madani Heart Hospital, Tabriz University of Medicine, Tabriz, Iran
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Ashida T, Tani S, Nagao K, Yagi T, Matsumoto N, Hirayama A. Usefulness of synthesized 18-lead electrocardiography in the diagnosis of ST-elevation myocardial infarction: A pilot study. Am J Emerg Med 2017; 35:448-457. [PMID: 27931763 DOI: 10.1016/j.ajem.2016.11.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/20/2016] [Accepted: 11/23/2016] [Indexed: 10/20/2022] Open
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Shahar K, Darawsha W, Yalonetsky S, Lessick J, Kapeliovich M, Dragu R, Mutlak D, Reisner S, Agmon Y, Aronson D. Time Dependence of the Effect of Right Ventricular Dysfunction on Clinical Outcomes After Myocardial Infarction: Role of Pulmonary Hypertension. J Am Heart Assoc 2016; 5:JAHA.116.003606. [PMID: 27402233 PMCID: PMC5015396 DOI: 10.1161/jaha.116.003606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background The clinical importance of right ventricular (RV) function in acute myocardial infarction is well recognized, but the impact of concomitant pulmonary hypertension (PH) has not been studied. Methods and Results We studied 1044 patients with acute myocardial infarction. Patients were classified into 4 groups according to the presence or absence of RV dysfunction and PH, defined as pulmonary artery systolic pressure >35 mm Hg: normal right ventricle without PH (n=509), normal right ventricle and PH (n=373), RV dysfunction without PH (n=64), and RV dysfunction and PH (n=98). A landmark analysis of early (admission to 30 days) and late (31 days to 8 years) mortality and readmission for heart failure was performed. In the first 30 days, RV dysfunction without PH was associated with a high mortality risk (adjusted hazard ratio 5.56, 95% CI 2.05–15.09, P<0.0001 compared with normal RV and no PH). In contrast, after 30 days, mortality rates among patients with RV dysfunction were increased only when PH was also present. Compared with patients having neither RV dysfunction nor PH, the adjusted hazard ratio for mortality was 1.44 (95% CI 0.68–3.04, P=0.34) in RV dysfunction without PH and 2.52 (95% CI 1.64–3.87, P<0.0001) in RV dysfunction with PH. PH with or without RV dysfunction was associated with increased risk for heart failure. Conclusion In the absence of elevated pulmonary pressures, the risk associated with RV dysfunction after acute myocardial infarction is entirely confined to the first 30 days. Beyond 30 days, PH is the stronger risk factor for long‐term mortality and readmission for heart failure.
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Affiliation(s)
- Keren Shahar
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Wisam Darawsha
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Sergey Yalonetsky
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Jonathan Lessick
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Michael Kapeliovich
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Robert Dragu
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Diab Mutlak
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Shimon Reisner
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Yoram Agmon
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Doron Aronson
- Department of Cardiology, Rambam Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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Pourafkari L, Joudi S, Ghaffari S, Tajlil A, Kazemi B, Nader ND. ST-Segment Elevation in the Right Precordial Leads in Patients with Acute Anterior Myocardial Infarction. Balkan Med J 2016; 33:58-63. [PMID: 26966619 DOI: 10.5152/balkanmedj.2015.15975] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 06/15/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Elevation of ST segment in leads V3R/ V4R, which is commonly encountered in right ventricular myocardial infarction, may also occur in patients with anterior ST elevation myocardial infarction (STEMI). However, the clinical impact of this finding in the setting of anterior myocardial infarction is not well understood. AIMS We aimed to investigate the prognostic value of ST segment elevation in leads V3R/V4R in patients with first acute anterior myocardial infarction. STUDY DESIGN Prospective cohort study. METHODS Right precordial leads V3R/V4R were recorded in 111 patients admitted with first time anterior myocardial infarction. Patients were allocated into two groups based on the presence or absence of ST elevation in leads V3R/V4R. Demographic, biochemical and echocardiographic data, as well as the angiographic information, were recorded. In-hospital and 3 month mortality, and major adverse cardiac events (MACE), death, heart failure and ventricular dysrhythmia were also compared. RESULTS ST elevation in lead V3R or V4R was present in 72 out of 111 patients (64.9%). Involvement of the proximal part of the left anterior descending (LAD) artery was not different in the two groups (44.4% of patients with elevation vs. 53.8% of patients without elevation, p=0.22). Post-myocardial infarction complications, mortality and major adverse cardiac events were similar in the two groups. Left ventricular ejection fraction (LVEF) was significantly lower in patients with ST elevation in V3R/V4R (35 %±8 vs. 38 %±8, p=0.02). Twenty three out of 111 patients (20.7%) developed heart failure, which was similar in the two groups [16 (22.2%) of patients with ST elevation vs. 7 (17.9%) of patients without ST elevation, p=0.39]. CONCLUSION Although ST elevation in V3R/V4R can be present in patients with left anterior descending artery occlusion, it does not seem to predict the prognosis. Lower left ventricular ejection fraction in this group may play a role in the long-term prognosis; however, this issue needs further investigation.
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Affiliation(s)
- Leili Pourafkari
- Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular Research Center, Tabriz, Iran
| | - Saeid Joudi
- Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular Research Center, Tabriz, Iran
| | - Samad Ghaffari
- Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular Research Center, Tabriz, Iran
| | - Arezou Tajlil
- Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular Research Center, Tabriz, Iran
| | - Babak Kazemi
- Department of Cardiology, Tabriz University of Medical Sciences Cardiovascular Research Center, Tabriz, Iran
| | - Nader D Nader
- Department of Anesthesiology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, New York, USA
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9
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Bonanad C, Ruiz-Sauri A, Forteza MJ, Chaustre F, Minana G, Gomez C, Diaz A, Noguera I, de Dios E, Nunez J, Mainar L, Sanchis J, Morales JM, Monleon D, Chorro FJ, Bodi V. Microvascular obstruction in the right ventricle in reperfused anterior myocardial infarction. Macroscopic and pathologic evidence in a swine model. Thromb Res 2013; 132:592-8. [PMID: 24007796 DOI: 10.1016/j.thromres.2013.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/05/2013] [Accepted: 08/14/2013] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Data on right ventricular (RV) involvement in anterior myocardial infarction are scarce. The presence of RV microvascular obstruction (MVO) in this context has not been analyzed yet. The aim of the present study was to characterize the presence of MVO in the RV in a controlled experimental swine model of reperfused anterior myocardial infarction. MATERIALS AND METHODS Left anterior descending (LAD) artery-perfused area (thioflavin-S staining after selective infusion in LAD artery), infarct size (lack of triphenyltetrazolium-chloride staining) and MVO (lack of thioflavin-S staining in the core of the infarcted area) in the RV were studied. A quantitative (% of the ventricular volume) and semiquantitative (number of segments involved) analysis was carried out both in the RV and LV in a 90-min left anterior descending balloon occlusion and 3-day reperfusion model in swine (n=15). RESULTS RV infarction and RV MVO (>1 segment) were detected in 9 (60%) and 6 (40%) cases respectively. Mean LAD-perfused area, infarct size and MVO in the RV were 33.8 ± 13%, 13.53 ± 11.7% and 3.4 ± 4.5%. Haematoxylin and eosin stains and electron microscopy of the RV-MVO areas demonstrated generalized cardiomyocyte necrosis and inflammatory infiltration along with patched hemorrhagic areas. Ex-vivo nuclear magnetic resonance (T2 sequences) microimaging of RV-MVO showed, in comparison with remote non-infarcted territories, marked hypointense zones (corresponding to necrosis, inflammation and hemorrhage) in the core of hyperintense regions (corresponding to edema). CONCLUSIONS In reperfused anterior myocardial infarction, MVO is frequently present in the RV. It is associated with severe histologic repercussion on the RV wall. Nuclear magnetic resonance appears as a promising technique for the noninvasive detection of this phenomenon. Further studies are warranted to evaluate the pathophysiological and clinical implications.
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Affiliation(s)
- Clara Bonanad
- Department of Cardiology, Hospital Clinico Universitario, INCLIVA, University of Valencia, Spain
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Masci PG, Francone M, Desmet W, Ganame J, Todiere G, Donato R, Siciliano V, Carbone I, Mangia M, Strata E, Catalano C, Lombardi M, Agati L, Janssens S, Bogaert J. Right ventricular ischemic injury in patients with acute ST-segment elevation myocardial infarction: characterization with cardiovascular magnetic resonance. Circulation 2010; 122:1405-12. [PMID: 20855663 DOI: 10.1161/circulationaha.110.940254] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Experimental data show that the right ventricle (RV) is more resistant to ischemia than the left ventricle. To date, limited data are available in humans because of the difficulty of discriminating reversible from irreversible ischemic damage. We sought to characterize RV ischemic injury in patients with reperfused myocardial infarction using cardiovascular magnetic resonance. METHODS AND RESULTS In 3 tertiary centers, 242 consecutive patients with reperfused acute ST-segment elevation myocardial infarction were studied with cardiovascular magnetic resonance at 1 week and 4 months after myocardial infarction. T2-weighted and postcontrast cardiovascular magnetic resonance scans were used to depict myocardial edema and late gadolinium enhancement, respectively. Early after infarction, RV edema was common (51% of patients), often associated with late gadolinium enhancement (31% of patients). Remarkably, RV edema and late gadolinium enhancement were found in 33% and 12% of anterior left ventricular infarcts, respectively. Baseline regional and global RV functions were inversely related to the presence and extent of RV edema and RV late gadolinium enhancement. At follow-up, a significant decrease in frequency (25/242 patients; 10%) and extent of RV late gadolinium enhancement was observed (P<0.001). With the use of multivariable analysis, the presence of RV edema was an independent predictor of RV global function improvement during follow-up (β-coefficient=0.221, P=0.003). CONCLUSIONS Early postinfarction RV ischemic injury is common and is characterized by the presence of myocardial edema, late gadolinium enhancement, and functional abnormalities. RV injury is not limited to inferior infarcts but is commonly found in anterior infarcts as well. Cardiovascular magnetic resonance findings suggest reversibility of acute RV dysfunction with limited permanent myocardial damage at 4-month follow-up.
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Affiliation(s)
- Pier Giorgio Masci
- Department of Radiology, Medical Imaging Research Center, UZ Leuven, Herestraat 49, Leuven, Belgium
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Bodi V, Sanchis J, Mainar L, Chorro FJ, Nunez J, Monmeneu JV, Chaustre F, Forteza MJ, Ruiz-Sauri A, Lopez-Lereu MP, Gomez C, Noguera I, Diaz A, Giner F, Llacer A. Right ventricular involvement in anterior myocardial infarction: a translational approach. Cardiovasc Res 2010; 87:601-8. [PMID: 20304784 DOI: 10.1093/cvr/cvq091] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS The aim of the present study was to evaluate the involvement of the right ventricle (RV) in reperfused anterior ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS Left anterior descending (LAD)-perfused area (using thioflavin-S staining after selective infusion in proximal LAD artery, %), infarct size (using triphenyltetrazolium chloride staining, %), and salvaged myocardium (% of LAD-perfused area) in the right and left ventricle (LV) were quantified in a 90-min LAD occlusion 3-day reperfusion model in swine (n = 8). Additionally, we studied, using cardiovascular magnetic resonance, 20 patients with a first STEMI due to proximal LAD occlusion treated with primary angioplasty. Area at risk (T2-weighted sequence, %), infarct size (late enhancement imaging, %), and salvaged myocardium (% of area at risk) in the right and LV were quantified. In swine, a large LAD-perfused area was detected both in the right and LV (30 +/- 5 vs. 62 +/- 15%, P< 0.001) but more salvaged myocardium (94 +/- 6 vs. 73 +/- 11%, P< 0.001) resulted in a smaller right ventricular infarct size (2 +/- 1 vs. 16 +/- 5%, P< 0.001). Similarly, in patients a large area at risk was detected both in the right and LV (34 +/- 13 vs. 43 +/- 12%, P = 0.02). More salvaged myocardium (94 +/- 10 vs. 33 +/- 26%, P < 0.001) resulted in a smaller infarct size (2 +/- 3 vs. 30 +/- 16%, P< 0.001) in the RV. CONCLUSION In reperfused extensive anterior STEMI, a large area of the RV is at risk but the resultant infarct size is small.
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Affiliation(s)
- Vicente Bodi
- Department of Cardiology, Hospital Clinico Universitario, INCLIVA, University of Valencia, Blasco Ibanez 17, Valencia 46010, Spain.
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Engström AE, Vis MM, Bouma BJ, van den Brink RB, Baan J, Claessen BE, Kikkert WJ, Sjauw KD, Meuwissen M, Koch KT, de Winter RJ, Tijssen JG, Piek JJ, Henriques JP. Right ventricular dysfunction is an independent predictor for mortality in ST-elevation myocardial infarction patients presenting with cardiogenic shock on admission. Eur J Heart Fail 2010; 12:276-82. [DOI: 10.1093/eurjhf/hfp204] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Annemarie E. Engström
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Marije M. Vis
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Berto J. Bouma
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Renée B.A. van den Brink
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Jan Baan
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Bimmer E.P.M. Claessen
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Wouter J. Kikkert
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Krischan D. Sjauw
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Martijn Meuwissen
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Karel T. Koch
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Robbert J. de Winter
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Jan G.P. Tijssen
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - Jan J. Piek
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
| | - José P.S. Henriques
- Department of Cardiology; Academic Medical Center; Meibergdreef 9 Amsterdam 1105 AZ The Netherlands
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Acute anterior wall myocardial infarction entailing ST-segment elevation in lead V3R, V1 or aVR: electrocardiographic and angiographic correlations. J Electrocardiol 2008; 41:329-34. [DOI: 10.1016/j.jelectrocard.2007.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2007] [Accepted: 12/05/2007] [Indexed: 11/19/2022]
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Samsamshariat SA, Movahed MR. High rate of right ventricular infarction after ligation of mid left anterior descending artery in rats. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2006; 6:21-3. [PMID: 16263352 DOI: 10.1016/j.carrev.2005.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2005] [Revised: 04/19/2005] [Accepted: 04/20/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND The left anterior descending artery (LAD) supplies the left ventricle in humans. LAD ligation has been commonly used in rats to induce left ventricular (LV) infarction for research purposes. However, the myocardial supply territories of LAD are not well established in rats. We measured the infarction zone in rats after ligation of the mid-LAD. METHODS Twenty-four male Sprague-Dawley rats weighing 300-350 g were selected for LAD ligation for the induction of ischemic cardiomyopathy. The surgery was performed under full anesthesia. Left-sided thoracotomy was performed through cuts in the fifth and sixth ribs. Ligation of the LAD was performed 1 to 2 mm distal to a line between the left border of the pulmonary conus and the right border of the left atrial appendage. LAD was ligated after the first diagonal and septal branches. After 24 h, the hearts were removed and stained with Tetrazolium Tetrachloride (TTC) for the detection of infracted areas. RESULTS Ligation of LAD induces 85% infarction of the right anterior free wall and anterior right ventricular septum and induces 100% infarction of the anterior free wall of the left ventricle and anterior septum. Infarction after LAD ligation extends all the way to the distal of the ligation site down to the apex of the heart. CONCLUSIONS Mid-LAD ligation after the first septal and diagonal branches causes substantial right ventricular infarction in addition to LV infarct in rats. Therefore, the hemodynamic effect of right ventricle infarct should be considered in research involving LAD ligation in rats.
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Affiliation(s)
- Seyed Ahmad Samsamshariat
- Division of Endocrinology, Department of Medicine, University of California, Irvine Medical Center, Orange, CA 92868, USA
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Masugata H, Senda S, Fujita N, Mizushige K, Ohmori K, Kohno M. Spatial distribution of right ventricular perfusion abnormalities following acute right coronary artery occlusion: a study by myocardial contrast echocardiography and blue dye staining. Int J Cardiovasc Imaging 2005; 21:599-607. [PMID: 16322918 DOI: 10.1007/s10554-005-2371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Accepted: 02/16/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although echocardiography is used for diagnosing right ventricular (RV) infarction produced by right coronary artery (RCA) occlusion, there has been no data on the spatial distribution of RV perfusion abnormalities following acute RCA occlusion. We examined this distribution by myocardial contrast echocardiography (MCE) and blue dye staining in canine models. METHODS The RCA was occluded in 10 open-chest dogs. MCE was performed with 0.27 g/min Levovist infusion by harmonic power Doppler with electrocardiogram gated intermittent triggered imaging at baseline and at 90 min after RCA occlusion. The opacification defects were assessed at the basal, middle, and apical levels of the RV free wall by short-axis view. The extent of the risk area of the occluded RCA, expressed as a percentage of the RV free wall, was measured at each level by injecting blue dye at the end of the experiments. In 10 other dogs, the left anterior descending coronary artery (LAD) was occluded by ligating the proximal portion of the LAD to examine the territory of the LAD on the same levels of the RV free wall by injecting blue dye. RESULTS Although patchy opacification defects accompanying RV dilation were observed at the basal and middle levels during RCA occlusion, no apical defects were observed in any dogs by MCE. The risk area of the occluded RCA, as delineated by blue dye, was larger in the basal than apical level of the RV free wall in all 10 dogs (basal: 79 +/- 9%; middle: 48 +/- 14%; apical: 3 +/- 6%, p < 0.0001). The risk area of the occluded LAD (basal: 17 +/- 7%; middle: 12 +/- 6%; apical: 6 +/- 6%) was smaller than the risk area of the occluded RCA at the basal and middle levels of the RV free wall (p < 0.0001), and no significant difference was observed at the apical level. CONCLUSIONS RV perfusion abnormalities produced by RCA occlusion are larger in the basal than apical level of the RV free wall. This finding elucidates the spatial distribution of the territory of the RCA on the RV free wall, and may help in identifying and assessing RV ischemia by echocardiography in humans. Moreover, the data in the current study indicate that RV infarction may be produced by occlusion of the coronary arteries except RCA, because the territory of the LAD on the RV free wall is clearly delineated.
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Affiliation(s)
- Hisashi Masugata
- Second Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kita, Kagawa, 761-0793, Japan.
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