Right ventricular dysfunction after thrombolysis in patients with right ventricular infarction

Background: Right ventricular (RV) infarction Is frequently associated with highest risk of death and major complications. Doppler echocardiography ca n be useful in the diagnosis of RV involvement. The goal of this study was to evaluate Doppler echocardiography features associated with RV involvemen t and a poor prognosis. Methods: Two-dimensional Doppler echocardiography was performed before and after thrombolysis in 108 consecutive patients with an RV infarction. The b edside examination was performed before and 2 to 3 hours after thrombolytic therapy, and repeated after 1 and 7 days. All patients underwent coronary angiography after 20 days, and the perfusion of the coronary-related artery (> thrombolysis in myocardial infarction [TIMI] 3 grade) was evaluated. Results: Patients were divided into 2 groups according to the recovery of g lobal and regional RV function after thrombolytic therapy. In the group of patients who showed a normalization or improvement of RV wall motion (as as sessed by RV wall motion score index), we found a TIMI grade III perfusion in 78% of patients. The analysis of interatrial septal motion and intervent ricular septal motion showed a normalization in all reperfused patients. Ma jor complication and deaths were more frequent in patients with echocardiog raphic findings of RV dysfunction persisting after thrombolytic therapy. Conclusion: In patients with RV infarction treated with thrombolysis, persi stent RV dysfunction is associated with a higher risk for the development o f major cardiac complications and death.