Prognostic significance of persistent right ventricular dysfunction as assessed by radionuclide angiocardiography in patients with inferior wall acute myocardial infarction

We evaluated cardiac hemodynamics and long-term prognosis in patients with right ventricular (RV) acute myocardial infarction (AMI) using Fourier phas e and amplitude analysis of radionuclide angiocardiographic scanning. In 14 3 patients with RV AMI, delayed phase and low amplitude in radionuclide RV images persisted in 54 patients (persistent RV dysfunction group) 3 months after AMI, but disappeared in the remaining 89 patients (improved RV functi on group). No significant differences were present in RV dimensions, left v entricular (LV) wall motion, LV election fraction, or RV election fraction between these groups during the acute phase. At 3 months, RV dimension and LV and RV wall motion indexes were significantly higher (p = 0.0292, p = 0. 0124, p <0.0001, respectively), and LV and RV ejection fractions were lower (p = 0.0174 and p = 0.0008, respectively) in the persistent RV dysfunction group. Percutaneous transluminal coronary angioplasty in the acute phase w as performed in a smaller group of patients (15% vs 34%, p = 0.0223), and t he degree of residual stenosis in the proximal right coronary artery was si gnificantly greater in the persistent RV dysfunction group than in the impr oved RV function group (82 +/- 22% vs 53 +/- 30%, p <0.0001). The 8-year su rvival rate was significantly lower in the persistent RV dysfunction group (p <0.0001). Persistent abnormality of phase and amplitude in radionuclide RV images was a significant independent predictor of long-term survival (od ds ratio 10.42; 95% confidence interval 3.65 to 29.71; p <0.0001). Radionuc lide angiocardiographic Fourier phase and amplitude scanning can detect per sistent RV dysfunction in patients with RV AMI and can predict patient outc ome. (C) 2000 by Excerpta Medica, Inc.