Factors associated with right ventricular dilatation in coronary artery disease patients with prior Q-wave myocardial infarction

Abstract

Factors associated with right ventricular (RV) dilatation in patients with prior Q-wave myocardial infarction (MI) have been determined. Out of 16839 patients from Register of performed coronary angiography we selected those with prior Q-wave MI who had no congenital heart disease: 1263 patients without RV dilatation and 99 patients with RV dilatation. There were more males in the group with RV dilatation (97.0 vs 89.6%, p = 0.018). Mean body mass index (BMI) was higher in this group (31.05.1 vs 29.44.6 kg/m <sup>2</sup>, p = 0.003). Patients with RV dilatation more often had a higher New-York Heart Association (NYHA) functional class (III/IV - 50.5 vs 17.4%) and arrhythmias (45.5 vs 17.8%, both p<0.001). Mean left ventricular (LV) mass index determined by echocardiography was higher in patients with RV dilatation (168.444.5 vs 136.031.0 g/m <sup>2</sup>). This group often demonstrated a reduced LV systolic function (71.7 vs 32.9%) and significant mitral regurgitation (52.5 vs 12.4%, all p<0.001). There were less frequent lesions of the diagonal branch of the left circumflex artery in patients with dilated RV (5.1 vs 12.1%, p = 0.035). According to our mulrivariate analysis, RV dilatation was predominantly associated with male gender, increased BMI and parameters describing the severity of LV dysfunction and remodeling.