Evaluation of right ventricular function in patients undergoing coronary intervention and presenting with non-ST-segment elevation myocardial infarction (NSTEMI)

Abstract

Background: Following an acute myocardial infarction (MI), right ventricular (RV) affection had been linked to increased morbidity and  death. In individuals with acute myocardial ischemia, RV dysfunction has been identified as a predictor of death. The aim of this work is to  evaluate the right ventricular function in patients undergoing coronary intervention and presenting with non-STsegment elevation  myocardial infarction (NSTEMI).

Methods: The study was a case control study that included 44 individuals over the age of 18 who were  hospitalized or referred to Zagazig University Hospital and National Heart Institute with manifestations of NSTEMI between 2019 and  2020. Patients were split into two groups based on their RV function: Group I (n = 22 patients) had normal RV function, and Group II (n =  22 patients) had impaired RV function. All patients were subjected to complete history, full clinical examination, ECG, echocardiography to  assess RV function, laboratory investigations and PCI then follow up for three months to evaluate improvement in RV function.  

Results: There was a statistically significant negative correlation between baseline TAPSE and peak Tpn and RVEDD. There was also a  statistically high significant positive correlation between baseline TAPSE and RVFAC. In addition, there was a statistically high significant  negative correlation between RVFAC and RVEDD with p value ≤0.001.

Conclusion: Patients with NSTEMI and poor RV function should be treated by PCI revascularization of the culprit lesion to enhance RV function, and it should be assessed by ECG and 2D echocardiography