What question did this study set out to answer?

This study aimed to analyze how right coronary artery revascularization impacts right ventricular function after acute inferior wall myocardial infarction.

December 10, 2022Global Cardiology Science and PracticeOpen Access

Impact of percutaneous coronary intervention in right coronary artery on right ventricular function in patients with acute myocardial infarction

Q: What are the key findings of this study?

Percutaneous coronary intervention of the right coronary artery significantly improved right ventricular function, with 81.82% of patients with baseline dysfunction showing recovery in TAPSE.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute inferior wall myocardial infarction with isolated right coronary artery lesions (n=59). Intervention: Percutaneous coronary intervention (PCI) of the right coronary artery vs. Pre-PCI baseline (within-subject comparison). Primary outcome: Improvement in right ventricular dysfunction (TAPSE < 17 mm) following PCI.

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Key result

RCA PCI linked to TAPSE recovery in ~82% of patients with baseline RV dysfunction.

n=59

Why the study?

Although elective PCI reduces left ventricular myocardial damage, information regarding the effect of PCI on RV function after acute myocardial infarction was lacking.

Does right coronary artery (RCA) revascularization via PCI improve right ventricular systolic and diastolic functions in patients with acute inferior wall myocardial infarction?

Population

Fifty-nine patients with acute inferior wall myocardial infarction after RCA revascularization

Comparison

Before vs after PCI

Design

Prospective observational study

Authors

MRMalladi Srinivasa RaoGovernment General Hospital

Discussion

Member takes

Implication

May support RCA PCI for RV recovery in inferior MI; leaves open confirmation in randomized trials.

Key Points

This study aimed to analyze how right coronary artery revascularization impacts right ventricular function after acute inferior wall myocardial infarction.
Prospective investigation of 59 patients diagnosed with acute inferior wall myocardial infarction.
Patients underwent 2D echocardiography before and after percutaneous coronary intervention.
Echocardiographic parameters for RV systolic and diastolic functions were compared.
RV systolic and diastolic functions improved significantly after PCI with TAPSE increasing from 37.29% to 81.82%.
S´ velocity increased significantly in mid RCA (p=0.008) and E/e´ improved in proximal RCA (p=0.021).
Overall echocardiographic parameters for patients with RV dysfunction showed remarkable improvement post-PCI.

Study Design

Type

Cohort (n=59)

Multicenter

Structured PICO

Does right coronary artery (RCA) revascularization via PCI improve right ventricular systolic and diastolic functions in patients with acute inferior wall myocardial infarction?

Population

n=59 patients diagnosed with acute inferior wall myocardial infarction prospectively investigated between April 2018 and January 2020

Intervention

Right coronary artery (RCA) revascularization via percutaneous coronary intervention (PCI)

Comparator

Pre-PCI baseline (before and after comparison)

Outcome

Right ventricular (RV) systolic and diastolic functions (TAPSE, RVFAC, E/A, S' velocity, E/e') measured by 2D echocardiographysurrogate

RCA revascularization via PCI significantly improves right ventricular systolic and diastolic function in patients with acute inferior wall myocardial infarction.

Limitations

Single-center study with a small sample size
Only included patients with single vessel (RCA) coronary artery disease, excluding multivessel disease
No investigation was conducted on the size and length of the stents used during RCA revascularization

Cite This Study

Malladi Srinivasa Rao (2022) conducted a cohort in Acute inferior wall myocardial infarction with isolated right coronary artery lesions (n=59). Percutaneous coronary intervention (PCI) of the right coronary artery vs. Pre-PCI baseline (within-subject comparison) was evaluated on Improvement in right ventricular dysfunction (TAPSE < 17 mm) following PCI. Percutaneous coronary intervention of the right coronary artery significantly improved right ventricular function, with 81.82% of patients with baseline dysfunction showing recovery in TAPSE.

synapsesocial.com/papers/6a0d291cd7cdc72b866566ca https://doi.org/10.21542/gcsp.2022.15

Topics

Echocardiography Percutaneous coronary intervention

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Impact of percutaneous coronary intervention in right coronary artery on right ventricular function in patients with acute myocardial infarction

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Impact of percutaneous coronary intervention in right coronary artery on right ventricular function in patients with acute myocardial infarction

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider