Analysis of related factors affecting right ventricular function after revascularization of acute anterior myocardial infarction / 中国基层医药

ABSTRACT

Objective:To explore the clinical value of echocardiography in right ventricle(RV) function after revascularization in patients with acute anterior ST-segment elevation myocardial infarction(STEMI) and the risk factor of RV dysfunction.Methods:From May 2017 to May 2019, 142 cases of acute anterior STEMI without RV myocardial infarction hospitalized in the People's Hospital of Zhuji were enrolled.All patients were successfully treated with emergency percutaneous coronary intervention(PCI) to treat infarction-related artery.According to the echocardiogram after operation, they were divided into normal RV function group and dysfunction group.The baseline data and echocardiographic parameters were compared between the two groups.The risk factors of RV dysfunction after emergency PCI in patients with acute anterior STEMI without RV myocardial infarction were analyzed by multivariate logistic regression.Results:There were 82 cases in normal RV function group and 60 cases in the RV dysfunction group.There were statistically significant differences in gender composition, left circumflex branch(LCX) lesions, and TIMI blood flow after PCI(χ 2=4.56, 27.47, 4.90, all P<0.05). The left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic diameter(LVEDD), and overall wall motion score index(WMSI) in the normal RV function group were (33.5±3.6)mm, (50.6±2.5)mm and(1.86±0.23), respectively, which in the RV dysfunction group were (36.6±5.3)mm, (51.7±4.0)mm, (2.07±0.10), respectively, the differences were statistically significant( t=4.15, 2.01, 6.61, all P<0.05). The left ventricular ejection fraction(LVEF) in the normal RV function group was higher than that in the RV dysfunction group( t=2.27, P<0.05). Multivariate logistic analysis showed that LCX mid-distal lesions, low TIMI blood flow, increased LVEDD and decreased LVEF were independent risk factors of RV dysfunction after emergency PCI in acute anterior STEMI without RV myocardial infarction. Conclusion:Echocardiography is helpful in evaluating RV function.Middle and distal LCX lesions, low TIMI flow, increased LVEDD and decreased LVEF are prone to RV dysfunction.