Right Ventricular Dysfunction Predicts Heart Failure And Mortality After Myocardial Infarction

Right ventricular function is an independent predictor of mortality and heart failure in patients with left ventricular dysfunction following myocardial infarction.

Previous studies have shown that right ventricular function predicts exercise capacity, autonomic imbalance and survival in patients with advanced heart failure.

Investigators from multiple institutions including the Cardiovascular Division at Brigham and Women’s Hospital at Harvard Medical School in Boston, Massachusetts, United States, evaluated the prognostic value of right ventricular function following myocardial infarction.

Two-dimensional echocardiograms from 416 patients with left ventricular dysfunction from the Survival And Ventricular Enlargement (SAVE) echocardiographic substudy were obtained. All patients had experienced myocardial infarction approximately 11.1 days earlier. Right ventricular function was assessed as a fractional change in cavity area from end diastole to end systole.

Univariate analysis showed that the right ventricular fractional area change was a predictor of mortality, cardiovascular mortality and heart failure. It was not a predictor of recurrent myocardial infarction.

Right ventricular function remained an independent predictor of mortality, cardiovascular mortality and heart failure after adjusting for age, gender, diabetes mellitus, hypertension, previous myocardial infarction, left ventricular function, infarct size, cigarette smoking and treatment.

Odds of cardiovascular mortality increased by 16 per cent for every 5 percent decrease in the right ventricular fractional area change.

J Am Coll Cardiol 2002; 39(9): 1450-1455. “Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction”