Key result
RV dysfunction after acute MI linked to ~265% higher 30-day major cardiovascular events risk.
Why the study?
Right ventricular dysfunction impacts prognosis after acute myocardial infarction, but the prognostic value of specific RV functional parameters after STEMI and NSTEMI was unclear.
Do right ventricular functional parameters (TAPSE, RVFAC, Tricuspid S' velocity) predict 30-day MACE in patients with first acute myocardial infarction?
Cohort (n=266)
Single-blind
No
Do right ventricular functional parameters (TAPSE, RVFAC, Tricuspid S' velocity) predict 30-day MACE in patients with first acute myocardial infarction?
Answers are grounded in this paper and cite their sources.
Echocardiographic parameters of right ventricular dysfunction (TAPSE, RVFAC, Tricuspid S' velocity) measured within 24 hours independently predict 30-day MACE after a first acute myocardial infarction.
OBJECTIVES: Right ventricular dysfunction impacts the prognosis of various heart diseases. We set-out to examine which right ventricular functional parameters after STEMI and NSTEMI have prognostic value. Of 297 eligible participants, 266 (149 STEMI and 117 NSTEMI) completed follow-up. All patients underwent Grace score and 2D-echocardiography within 24 h. Outcome was defined as occurrence of Major Adverse Cardiovascular events (MACE), such as death, recurrent ischaemia, arrhythmia, reinfarction, stroke or heart failure, within 30 days. Patients were categorized into patients with MACE and patients without MACE. RESULTS: In STEMI-patients, compared to those without MACE, patients with MACE experienced higher grace score, left ventricle (LV) end-systolic volume, LV end-systolic dimension and wall motion score index values, but lower tricuspid annular plane systolic excursion, right ventricle (RV) fractional area change, Tricuspid S' wave peak systolic velocity and LV ejection fraction. Nevertheless, in NSTEMI-patients, those with MACE exhibited higher left atrial volume index values, but lower tricuspid annular plane systolic excursion, RV fractional area change, S' wave peak systolic velocity and LVEF. Right ventricular fractional area change < 37.5%, tricuspid annular plane systolic excursion < 15.8 mm and Tricuspid S' peak systolic velocity < 9.67 cm/s are independent predictors of MACE within first 30 days after STEMI and NSTEMI.
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Awad et al. (2020) conducted a cohort in Acute myocardial infarction (STEMI and NSTEMI) (n=266). Right ventricular dysfunction (RVFAC < 35%) vs. Normal right ventricular function was evaluated on Major Adverse Cardiovascular events (MACE) within 30 days (OR 3.65, 95% CI 1.95-6.85, p=<0.001). Right ventricular dysfunction after acute myocardial infarction increased the odds of 30-day major adverse cardiovascular events compared to normal function.
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