FACTORS ASSOCIATED WITH SYSTOLIC DYSFUNCTION OF THE RIGHT VENTRICLE IN PATIENTS WITH A HISTORY OF MYOCARDIAL INFARCTION

Аннотация

The article describes a study that analyzed the features of right ventricular involvement in patients who had suffered a myocardial infarction (MI), taking into account the assessment of global contractility of both the left and right ventricles. The examination of MI patients included biomarker analysis and echocardiography (EchoCG). The aim of the study was to analyze the factors influencing the development of right ventricular dysfunction in MI patients with impaired left ventricular contractile function. A total of 144 patients with previous myocardial infarctions of different localizations and decreased left ventricular ejection fraction underwent examination. Patients were divided into two groups: the first group (n=42) with right ventricular involvement, and the second group (n=102) without right ventricular involvement in the pathological process. According to the study findings, the frequency of right ventricular systolic dysfunction among patients with a history of myocardial infarction was 29.2%. Patients with right ventricular dysfunction were more prone to higher (III–IV) functional classes of chronic heart failure according to the New York Heart Association classification [17] (66.7% vs. 19.6%, p<0.001). Right ventricular dilation was more frequently detected in the first group (71% vs. 27%, p<0.005). Echocardiography in patients with right ventricular dysfunction showed higher values of left ventricular end-diastolic volume (195.0±31.1 vs. 118.67±24.68 ml, p<0.005), systolic pulmonary artery pressure (31.76±12.7 vs. 22.33±5.4 mmHg, p<0.005), and more frequent left ventricular contractile function reduction (left ventricular ejection fraction 43.58±4.93% vs. 53.87±6.29%, p<0.001). Correlation analysis results showed an association between right ventricular dysfunction and left ventricular functional status. Thus, a decrease in right ventricular contractile capacity was detected in 29.2% of patients with ischemic heart disease who had suffered a myocardial infarction. Right ventricular systolic dysfunction was associated with decreased left ventricular ejection fraction, increased systolic pulmonary artery pressure, and functional class of heart failure.