Clinical and Echocardiographic Predictors of Cardiorenal Syndrome Type I in Patients with Acute Ischemic Right Ventricular Dysfunction

Abstract

Background: In current cardiology practice, the importance of acute cardiorenal syndrome (CRS) in determining the outcome of patients with acute coronary syndrome (ACS) is well recognized. Certain groups of ACS patients are at higher risk of developing CRS. Data on the association between right ventricular (RV) functions and CRS after acute myocardial infarction (AMI) are scarce. The purpose of the current study was to evaluate the relation between RV function and the development of CRS in patients presenting with inferior wall AMI and RV involvement. Patients and Methods: Patients with inferior wall AMI with RV involvement underwent echocardiography at admission to assess RV function. RV functions were quantified according to RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), and RV outflow tract fractional shortening (RVOTFS). The patients were followed up until discharge from hospital. All patients who developed CRS were included in group I, all patients who did not develop CRS were included in group II (controls). Multivariate analysis was carried out to determine the significance of the echocardiographic and clinical parameters in predicting the development of CRS in these patients. Results: In our study, a history of diabetes mellitus, cardiogenic shock at admission, and RVFAC and TAPSE could significantly predict the development of CRS in patients presenting with inferior wall AMI and RV involvement. Conclusions: RV functions provide strong prognostic information regarding the development of CRS in patients of inferior wall AMI with RV involvement.