Abstract
The purpose of this study was to investigate the impact of the right ventricular involvement as assessed on cardiac MRI (CMR) in patients with reperfused acute myocardial infarction (AMI). 147 patients with reperfused AMI were included in a prospective multicenter study (clinical trials: NCT 01113268). All patients underwent CMR imaging within 4 days following primary percutaneous coronary intervention (PPCI) and at 6 months follow-up. Right and left ventricular volumes and function were retrospectively calculated using dedicated software. Data study consisted of topography and size of myocardial infarction and of the microvascular obstruction measurements. Right and left ventricular remodeling were defined as end-diastolic volume (EDV) increase >20 between immediate CMR and 6-month follow-up. The presence of RV infarction was compared with the prevalence of LV and RV remodeling. All patients were successfully reperfused within first 6 hours after chest pain onset. Location of AMI was as follow: 82 (56%) had anterior MI, 44 (30%) had inferior MI and 21 (14%) had lateral MI. RV infarction was observed in 50 patients (34%) of the cohort. RV remodeling did not occur alone. It was observed in 51 patients (34.7%) and was associated with LV remodeling. A strong association between right and left ventricular remodeling was noted (p=0.027). RV involvement in AMI is not rare and is a good predictor of LV EF impairment at 6 months. LV and RV remodeling are strongly associated. LV infarct size and microvascular obstruction do not influence RV remodeling but have an important role in LV remodeling.
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