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Title: Prospective clinical, scintigraphic, angiographic and functional evaluation of patients after inferior myocardial infarction with and without right ventricular dysfunction

Abstract

To elucidate the functional and prognostic significance of right ventricular dysfunction after acute inferior wall myocardial infarction, 74 consecutive patients with inferior infarction were prospectively evaluated with gated equilibrium blood pool imaging at rest, submaximal exercise thallium-201 scintigraphy and coronary angiography before hospital discharge. In addition, symptom-limited stress thallium-201 scintigraphy was performed in 61 patients at 3 months, and all patients were followed up clinically for 23 +/- 15 months. Utilizing predetermined radionuclide angiographic criteria, 47 patients (Group I) had normal right ventricular function, 12 patients (Group II) had mild to moderate dysfunction and 15 patients (Group III) had severe right ventricular dysfunction. Exercise tolerance as assessed by treadmill time, blood pressure-heart rate product and peak work load in METS was comparable among the three groups, both before hospital discharge and at 3 month follow-up. No differences in indicators of exercise-induced ischemia were noted among the groups, including the prevalence of redistribution thallium-201 defects, ST segment depression or symptoms of chest pain. Finally, cardiac mortality, reinfarction rate and the incidence of medically refractory angina pectoris were similar in the three groups. Thus, right ventricular dysfunction after acute inferior wall myocardial infarction does not appear to limit exercise tolerance or identifymore » a subgroup of patients at higher risk for recurrent cardiac events.« less

Authors:
; ; ; ; ; ;
Publication Date:
Research Org.:
Univ. of Virginia Medical Center, Charlottesville
OSTI Identifier:
6044095
Resource Type:
Journal Article
Resource Relation:
Journal Name: J. Am. Coll. Cardiol.; (United States); Journal Volume: 5
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; HEART; BIOMEDICAL RADIOGRAPHY; SCINTISCANNING; MYOCARDIAL INFARCTION; DIAGNOSIS; BLOOD PRESSURE; EXERCISE; ISCHEMIA; MYOCARDIUM; PATIENTS; THALLIUM 201; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; MUSCLES; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; VASCULAR DISEASES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Haines, D.E., Beller, G.A., Watson, D.D., Nygaard, T.W., Craddock, G.B., Cooper, A.A., and Gibson, R.S. Prospective clinical, scintigraphic, angiographic and functional evaluation of patients after inferior myocardial infarction with and without right ventricular dysfunction. United States: N. p., 1985. Web. doi:10.1016/S0735-1097(85)80300-4.
Haines, D.E., Beller, G.A., Watson, D.D., Nygaard, T.W., Craddock, G.B., Cooper, A.A., & Gibson, R.S. Prospective clinical, scintigraphic, angiographic and functional evaluation of patients after inferior myocardial infarction with and without right ventricular dysfunction. United States. doi:10.1016/S0735-1097(85)80300-4.
Haines, D.E., Beller, G.A., Watson, D.D., Nygaard, T.W., Craddock, G.B., Cooper, A.A., and Gibson, R.S. Fri . "Prospective clinical, scintigraphic, angiographic and functional evaluation of patients after inferior myocardial infarction with and without right ventricular dysfunction". United States. doi:10.1016/S0735-1097(85)80300-4.
@article{osti_6044095,
title = {Prospective clinical, scintigraphic, angiographic and functional evaluation of patients after inferior myocardial infarction with and without right ventricular dysfunction},
author = {Haines, D.E. and Beller, G.A. and Watson, D.D. and Nygaard, T.W. and Craddock, G.B. and Cooper, A.A. and Gibson, R.S.},
abstractNote = {To elucidate the functional and prognostic significance of right ventricular dysfunction after acute inferior wall myocardial infarction, 74 consecutive patients with inferior infarction were prospectively evaluated with gated equilibrium blood pool imaging at rest, submaximal exercise thallium-201 scintigraphy and coronary angiography before hospital discharge. In addition, symptom-limited stress thallium-201 scintigraphy was performed in 61 patients at 3 months, and all patients were followed up clinically for 23 +/- 15 months. Utilizing predetermined radionuclide angiographic criteria, 47 patients (Group I) had normal right ventricular function, 12 patients (Group II) had mild to moderate dysfunction and 15 patients (Group III) had severe right ventricular dysfunction. Exercise tolerance as assessed by treadmill time, blood pressure-heart rate product and peak work load in METS was comparable among the three groups, both before hospital discharge and at 3 month follow-up. No differences in indicators of exercise-induced ischemia were noted among the groups, including the prevalence of redistribution thallium-201 defects, ST segment depression or symptoms of chest pain. Finally, cardiac mortality, reinfarction rate and the incidence of medically refractory angina pectoris were similar in the three groups. Thus, right ventricular dysfunction after acute inferior wall myocardial infarction does not appear to limit exercise tolerance or identify a subgroup of patients at higher risk for recurrent cardiac events.},
doi = {10.1016/S0735-1097(85)80300-4},
journal = {J. Am. Coll. Cardiol.; (United States)},
number = ,
volume = 5,
place = {United States},
year = {Fri Nov 01 00:00:00 EST 1985},
month = {Fri Nov 01 00:00:00 EST 1985}
}