Abstract 2395: The Impact of Right Ventricular Dysfunction on Long Term Mortality in Patients with Acute Myocardial Infarction
Aim: To assess the impact of right ventricular (RV) dysfunction on long-term mortality in patients with acute myocardial infarction.
Methods: We prospectively studied 1217 consecutive patients with AMI and RV function assessed by echocardiography in the first 24 hours from admission. They were followed-up for a mean of 17 months.
Results: Mild RV dysfunction was detected in 6.2%, moderate in 2.7% and severe in 1.3% of the patients. During the follow-up period, the overall mortality was 32.0%, 45.2% and 81.3% respectively, and only 9.3% in the normal RV function group (p<0.0001). After adjusting for age, gender, Killip class, on-admission blood pressure, diabetes mellitus, inferior wall involvement, ST-elevation AMI, creatinine clearance and left ventricular systolic function, the odds ratio for mortality were 3.07 (95% confidence interval [CI], 1.25–7.53, p<0.01), 3.89 (95%CI, 1.22–12.34, p<0.02) and 21.66 (95%CI, 3.12–150.03, p<0.002) for mild, moderate and severe RV dysfunction respectively, as compared to normal RV function group. Figure 1⇓ depicts the Kaplan-Meier cumulative probability for mortality curves for each group.
Conclusion: There is a graded independent association between the severity of RV dysfunction after AMI and long-term mortality. Even a mild dysfunction is associated with an increase in risk of death.