Clinical Features of Patients with Right Ventricle Dysfunction after Myocardial Infarction

The article conducted a study that analyzed the characteristics of right ventricular damage in patients with myocardial infarction (MI), and assessed global contractility of both the left and right ventricles. Patients with a history of MI underwent examination, which included determination of biomarkers and echocardiography (EchoCG).

Purpose of the study. Study of factors contributing to the development of right ventricular dysfunction in patients with myocardial infarction and impaired contractile function of the left ventricle.

Material and methods. 144 patients with previous myocardial infarction of different localization and with a decrease in left ventricular ejection fraction were examined. The patients were divided into two groups: the first group (n=42) with damage to the right ventricle, and the second group (n=102) without involvement of the right ventricle in the pathological process.

Results. According to the survey, the incidence of right ventricular systolic dysfunction among patients with myocardial infarction was 29.2%. Patients with right ventricular dysfunction were more likely to have higher (III–IV) functional classes of chronic heart failure according to the New York Heart Association classification [17] (66.7% vs. 19.6%, p<0.001). Right ventricular dilatation was more often detected in the first group (71% vs. 27%, p<0.005). When conducting echocardiography in patients with right ventricular dysfunction, higher values were observed: end-diastolic volume of the left ventricle (195.0±31.1 versus 118.67±24.68 ml, p<0.005), systolic pressure in the pulmonary artery (31.76±12.7 versus 22.33±5.4 mmHg, p<0.005), and a decrease in the contractile function of the left ventricle was more often noted (left ventricular ejection fraction 43.58±4.93% versus 53, 87±6.29%, p<0.001). The results of the correlation analysis showed the connection between right ventricular dysfunction and the functional state of the left ventricle.

Conclusion. Thus, a decrease in the contractility of the right ventricle was detected in 29.2% of patients with coronary artery disease who suffered a myocardial infarction. RV systolic dysfunction was associated with decreased LV ejection fraction, increased pulmonary artery systolic pressure (PASP) and functional class of chronic heart failure (CHF).