scholarly journals Subtle Right Ventricular Affection in Patients with Acute Myocardial Infarction, Echocardiographic Assessment

2020 ◽  
Vol 8 (B) ◽  
pp. 1212-1218
Author(s):  
Abdallah Mohamed ◽  
Shaaban Alramlawy ◽  
Samir El-Hadidy ◽  
Mohamed Ibrahiem Affify ◽  
Waheed Radwan
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Significant Relationship ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
The Right ◽  
And Function

BACKGROUND: The right ventricle (RV) has historically received less attention than its counterpart of the left side of the heart, yet there is a substantial body of evidence showing that RV size and function are perhaps equally important in predicting adverse outcomes in cardiovascular diseases. AIM: The aim of our work was to evaluate incidence and impact of right ventricular (RV) affection in patients with acute left ventricular myocardial infarction subjected to primary percutaneous coronary intervention (1ry PCI). METHODS: The study was conducted on 80 patients who had acute left ventricle ST elevated myocardial infarction (LV STEMI) and subjected to 1ry PCI. The study was done in Cairo University, critical care department. All patients were studied within 2 days after 1ry PCI, RV function was assessed by echocardiography through tricuspid annular plane systolic excursion (TAPSE) and speckle tracking echocardiography. We excluded patients with RV infarction, moderate to severe tricuspid regurgitation, pulmonary hypertension, dilated cardiomyopathy, atrial or ventricular septal defect, and patients who had cardiac dysrhythmias. RESULTS: Out of 80 patients (64 men and 16 women) included in the study, 38 patients (47.5%) had TAPSE <1.7 cm, and 48 patients (60%) had RV longitudinal strain less negative than −19%.There was a statistically significant relationship between RV affection and anterior STEMI, left anterior descending artery as an infarct-related artery, duration of intensive care unit stay, impairment of LV global and regional systolic function, in-hospital complications, and 1-year mortality. CONCLUSION: RV dysfunction is not uncommon in acute LV STEMI when using the definition of TAPSE <17 cm and RV longitudinal strain less negative than −19%.There was a significant relationship between RV dysfunction and poor outcome in patients with acute LV STEMI.

scholarly journals Title：Early assessment of ventricular synchronization and function after left bundle-branch-area pacing with right bundle-branch block

2021 ◽  
Author(s):  
Ruohan Zhao ◽  
Feng Xiong ◽  
Xiaoqi Deng ◽  
Shuzhen Wang ◽  
Chunxia Liu ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Ventricular Function ◽  
Right Bundle Branch Block ◽  
Longitudinal Strain ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Peak Strain ◽  
Bundle Branch Block ◽  
The Right ◽  
And Function

Aim To evaluate ventricular synchronization and function in patients with right bundle-branch block after left bundle-branch-area pacing (LBBAP) by echocardiography. Methods Forty patients who successfully received LBBAP were selected and divided into the right bundle-branch block group (RBBB group) and the non-RBBB group by pre-operation ECG. Echocardiography and follow-up were performed 1 month after operation. Interventricular synchronization was evaluated by tissue Doppler (TDI), tissue mitral annular displacement (TMAD), and interventricular mechanical delay (IVMD). The ventricular longitudinal strain and the standard deviation of peak time of longitudinal strain were analyzed by two-dimensional speckle tracking imaging (2D-STI) to evaluate intraventricular synchronization and ventricular function. Results (1) The deviation of systolic time to the peak of the tricuspid and mitral valves, namely ΔPTTV-MV measured by TMAD and ΔTsTV-MV measured by TDI, were statistically different between the two groups (P < 0.05). (2) Compared with the non-RBBB group, there were no statistically significant differences in longitudinal strain (LS), peak strain time, standard deviation of peak strain time (SDt), and global longitudinal strain (GLS) in the right and left ventricle in the RBBB group (P > 0.05). Conclusion Echocardiography technology including 2D-STI, TDI, and TMAD can effectively analyze interventricular synchronization, intraventricular synchronization, and ventricular function. Although the movement of the right ventricular myocardium in the RBBB group treatment was slightly later than that of the left ventricular myocardium after LBBAP, LBBAP is still an effective pacing therapy for RBBB patients with pacing indication.

scholarly journals Genetic Analysis of Right Heart Structure and Function in 40,000 People

2021 ◽  
Author(s):  
James P. Pirruccello ◽  
Paolo Di Achille ◽  
Victor Nauffal ◽  
Mahan Nekoui ◽  
Samuel N. Friedman ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Deep Learning ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Left Ventricular ◽  
Structure And Function ◽  
Right Heart ◽  
Heart Chamber ◽  
The Right ◽  
And Function

The heart evolved hundreds of millions of years ago. During mammalian evolution, the cardiovascular system developed with complete separation between pulmonary and systemic circulations incorporated into a single pump with chambers dedicated to each circulation. A lower pressure right heart chamber supplies deoxygenated blood to the lungs, while a high pressure left heart chamber supplies oxygenated blood to the rest of the body. Due to the complexity of morphogenic cardiac looping and septation required to form these two chambers, congenital heart diseases often involve maldevelopment of the evolutionarily recent right heart chamber. Additionally, some diseases predominantly affect structures of the right heart, including arrhythmogenic right ventricular cardiomyopathy (ARVC) and pulmonary hypertension. To gain insight into right heart structure and function, we fine-tuned deep learning models to recognize the right atrium, the right ventricle, and the pulmonary artery, and then used those models to measure right heart structures in over 40,000 individuals from the UK Biobank with magnetic resonance imaging. We found associations between these measurements and clinical disease including pulmonary hypertension and dilated cardiomyopathy. We then conducted genome-wide association studies, identifying 104 distinct loci associated with at least one right heart measurement. Several of these loci were found near genes previously linked with congenital heart disease, such as NKX2-5, TBX3, WNT9B, and GATA4. We also observed interesting commonalities and differences in association patterns at genetic loci linked with both right and left ventricular measurements. Finally, we found that a polygenic predictor of right ventricular end systolic volume was associated with incident dilated cardiomyopathy (HR 1.28 per standard deviation; P = 2.4E-10), and remained a significant predictor of disease even after accounting for a left ventricular polygenic score. Harnessing deep learning to perform large-scale cardiac phenotyping, our results yield insights into the genetic and clinical determinants of right heart structure and function.

scholarly journals Sleep disordered breathing and enlargement of the right heart after myocardial infarction

2014 ◽  
Vol 45 (3) ◽  
pp. 680-690 ◽  
Author(s):  
Stefan Buchner ◽  
Michael Eglseer ◽  
Kurt Debl ◽  
Andrea Hetzenecker ◽  
Andreas Luchner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Right Atrial ◽  
Right Heart ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
The Right

Structural and functional integrity of the right heart is important in the prognosis after acute myocardial infarction (AMI). The objective of this study was to assess the impact of sleep disordered breathing (SDB) on structure and function of the right heart early after AMI.54 patients underwent cardiovascular magnetic resonance 3–5 days and 12 weeks after AMI, and were stratified according to the presence of SDB, defined as an apnoea–hypopnoea index of ≥15 events·h−1.12 weeks after AMI, end-diastolic volume of the right ventricle had increased significantly in patients with SDB (n=27)versusthose without (n=25) (mean±sd14±23%versus0±17%, p=0.020). Multivariable linear regression analysis accounting for age, sex, body mass index, smoking, left ventricular mass and left ventricular end-systolic volume showed that the apnoea–hypopnoea index was significantly associated with right ventricular end-diastolic volume (B-coefficient 0.315 (95% CI 0.013–0.617); p=0.041). From baseline to 12 weeks, right atrial diastolic area increased more in patients with SDB (2.9±3.7 cm2versus1.0±2.4 cm2, p=0.038; when adjusted for left ventricular end systolic volume, p=0.166).SDB diagnosed shortly after AMI predicts an increase of right ventricular end-diastolic volume and possibly right atrial area within the following 12 weeks. Thus, SDB may contribute to enlargement of the right heart after AMI.

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