September 2, 2020Heart
Frequency and prognostic impact of right ventricular involvement in acute myocardial infarction
Why the study?
Right ventricular involvement complicating myocardial infarction is thought to impact prognosis, but potent right ventricular markers for risk stratification are lacking.
Population
1235 patients with MI (STEMI n=795; non-STEMI n=440) after primary PCI
Comparison
Structural and functional RV alterations on CMR
Design
Prospective cohort study with core laboratory-masked CMR analysis
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
RV GLS may refine post-MI risk stratification beyond LV measures; leaves open incremental value pending prospective validation.
Structured PICO
P
Population
1,235 patients with acute myocardial infarction (STEMI: n=795; NSTEMI: n=440) evaluated 3 days after reperfusion by primary percutaneous coronary intervention
I
Intervention
Cardiac magnetic resonance (CMR) assessing structural (oedema, irreversible infarction, microvascular obstruction) and functional (ejection fraction, global longitudinal strain) right ventricular alterations
O
Outcome
12-month rate of major adverse cardiac events (MACE)composite
Right ventricular global longitudinal strain assessed by CMR provides independent prognostic value for adverse events following acute myocardial infarction, beyond established risk factors like left ventricular GLS and Killip class.
Cite This Study
Stiermaier et al. (2020) studied this question.