P286Ischemic right ventricular dysfunction predicts lower exercise capacity in patients after myocardial infarction.


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Abstract

Background: Right ventricular (RV) systolic myocardial velocity (SmRV) was shown to be an indicator of RV systolic function. RV dysfunction causes worsening of exercise capacity (EC) in patients with chronic heart failure but data on impact of RV function on EC in patients after inferior myocardial infarction (MI) with preserved left ventricle (LV) EF are scarce.Aim: To assess EC in patients with RV dysfunction complicating inferior MI in comparison to patients without RV dysfunction.Methods: We evaluated prospectively patients with first inferior MI with ST segment elevation treated by primary percutaneous coronary intervention (pPCI) and preserved or mildly impaired LV systolic function (EF LV ≥ 45%). ECHO was performed post pPCI within 48 hours from the onset of symptoms. RV systolic dysfunction was defined as SmRV<11,5 cm/s at the basal segment of RV free wall in pulse wave Tissue Doppler Echocardiography (TDE). Cardiopulmonary exercise test (CPET) was done on day 14±10. Oxygen uptake at peak exercise (VO2peak) and at anaerobic threshold (VO2-AT) and percent of predicted values (%) were assessed as EC parameters.Results: Patients (n=90, 75,5% males, mean age 60,5±10 years) were divided into two groups: the group with RV systolic dysfunction (n=49, 77% males, mean age 60,4 ± 9,1 years) and the group without RV dysfunction (n=41, 80% males, mean age 60±9 years). The group with RV dysfunction has a significant lower EC measured as percent of predicted values of VO2max (Table). LV systolic parameters and maximal troponin level have no impact on EC.Conclusion: RV systolic dysfunction assessed with TDE in patients after acute inferior MI, correlates well with other RV systolic parameters and has a significant impact on exercise capacity estimated with cardiopulmonary stress test.

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