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DOI: 10.31071/kit2017.13.04


Inventory reference ISSN 1812-7231 Klin.inform.telemed. Volume 12, Issue 13, 2017, Pages 30–34


Author(s) V.Y. Tseluyko1, T.A. Lozova2


Institution(s) 1Kharkov Medical Academy of Postgraduate education 2City Clinical Hospital N 1, Sumy


Article title The features of the coronary blood flow in the right ventricle myocardial infarction


Abstract (resume)

Introduction. Due to the adverse effect of the right ventricular (RV) myocardial infarction (MI) on the prognosis, it is important to study the features of coronary blood flow in the case of RV MI.

Aim. To determine the features of the coronary affection in patients with RV IM on the background of the Q-MI of the left ventricle (LV).

Methods. The analysis of coronary angiography was performed in 140 patients during the first 12 months after Q-MI. In 68 patients (the 1st group) the RV MI was diagnosed on a background of the Q-IM of the posterior wall (PW) of the left ventricle (LV), in 27 patients (the 2nd group) - the RV MI was determined on the background of the LV MI with circulatory localization, and in 45 patients (control group) - Q-ІМ of the LV PW.

Results. The affection of two or more coronary arteries (CA) was significantly more often detected in patients with the RV MI in comparison to the isolated LV Q-MI. In the 1st group, the RV MI was induced by occlusion of the right coronary artery (RCA) in 91.4% of cases and by the stenosis of the circumflex CA (CxCA) in 5.9% of cases. The RV MI on the background of the LV MI with circular localization was caused by the proximal occlusion of the RCA (44.4%), the proximal occlusion of the CxCA (7.4%), the critical stenosis of the proximal parts of the RCA and the left anterior descending artery (LAD) (25.9%) and by the combined proximal subocclusion of the CxCA and LAD (7.4%).

Conclusion. The RV MI in patients with the LV Q-MI occurs in the most cases on the background of proximal occlusion of RCA and in the combination of the main trunks of the right and left CA affection. The incedences of the RV MI are associated with multivessel coronary artery disease.


Keywords right ventricle myocardial infarction, coronary artery, multivessel coronary artery disease, occlusion


References

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https://doi.org/10.1590/S1516-31802006000400003
PMid:17086298

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PMid:25173339

10. Bowers T., O’Neill W., Pica M. Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction. Circ J., 2002, vol. 106, pp. 1104–1109.
https://doi.org/10.1161/01.CIR.0000027566.51212.3F

11. Ding W., Wang X., Zhang J. Relationship between the site of coronary artery occlusion and degree of hemodynamic abnormality of right ventricular myocardial infarction. Zhonghua Nei Ke Za Zhi, 1997, vol. 36, iss. 10, pp. 676–679.
PMid:10436983

12. Pereira A., Franken R., Schwarzwälder S., Golin S.V. Impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular infarction. Sao Paulo Med J., 2006, vol.124, iss. 4, pp.186-191.
https://doi.org/10.1590/S1516-31802006000400003
PMid:17086298

13. Jacobs A. K., Leopold J.A., Bates E. Cardiogenic Shock Caused by Right Ventricular Infarction A Report From the SHOCK Registry. J Am Coll Cardiol., 2003, vol. 41, pp. 1273–1279
https://doi.org/10.1016/S0735-1097(03)00120-7

14. Stanley G., Mansi P., Ashok T. Clinical profile and in-hospital outcome of patients with right ventricular myocardial infarction. International Journal of Clinical Medicine, 2014, vol. 5, pp. 459-463.
https://doi.org/10.4236/ijcm.2014.58064

15. Lupi-Herrera E., Gonzalez-Pacheco H., Juarez-Herrera U. Primary reperfusion in acute right ventricular infarction: An observational study. World J. Cardiol., 2014, vol. 6, iss. 1, pp. 14-22.
PMid:24527184 PMCid:PMC3920162

16. Garty I., Barzilay J., Bloch L. The diagnosis and early complications of right ventricular infarction. Eur J Nucl Med., 1984, vol. 9, iss. 10, pp. 453-60.
https://doi.org/10.1007/BF00563168
PMid:6096148

17. Andersen H.R., Falk E., Nielsen D. Right ventricular infarction: Frequency, size and topography in coronary heart disease: A prospective study comprising. 107 consecutive autopsies from a coronary care unit. J Am Coll Cardiol., 1987, vol. 10, pp. 1223 - 1232.
https://doi.org/10.1016/S0735-1097(87)80122-5

18. Cabin H. S., Clubb K.S., Wackers F.J. Right ventricular myocardial infarction with anterior wall left ventricular infarction: An autopsy study. Am Heart J., 1987, vol. 113, pp. 16–23.
https://doi.org/10.1016/0002-8703(87)90004-4

19. Scanlon P., Faxon D, Audet A. ACC/AHA Guidelines for Coronary Angiography: Executive Summary and Recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) Developed in collaboration with the Society for Cardiac Angiography and Interventions. Circulation, 1999, vol. 99, pp. 2345–57.
https://doi.org/10.1161/01.CIR.99.17.2345
PMid:10226103

20. Windecker S., Kolh P., Alfonso F. 2014 ESC/EACTS Guidelines on myocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European Heart Journal, 2014, vol. 35, pp. 2541–2619.
https://doi.org/10.1093/eurheartj/ehu278
PMid:25173339

21. Bowers T., O’Neill W., Pica M. Patterns of Coronary Compromise Resulting in Acute Right Ventricular Ischemic Dysfunction. Circ J., 2002, vol. 106, pp. 1104–1109.
https://doi.org/10.1161/01.CIR.0000027566.51212.3F

22. Ding W., Wang X., Zhang J. Relationship between the site of coronary artery occlusion and degree of hemodynamic abnormality of right ventricular myocardial infarction. Zhonghua Nei Ke Za Zhi, 1997, vol. 36, iss. 10, pp. 676–679.
PMid:10436983


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