Impact of percutaneous coronary intervention in the right coronary artery on right ventricular function in patients with acute myocardial infarction

Abstract

Background: Right ventricular (RV) dysfunction is a potent predictor of mortality and morbidity after acute myocardial infarction (MI). Even though elective percutaneous coronary intervention (PCI) has significantly decreased myocardial damage of the left ventricle; in literature, there has been a lack of information regarding the effect of PCI on RV function. Objective: The objective of this study is to examine the effect of the right coronary artery (RCA) revascularization on systolic and diastolic functions of the right ventricle following acute inferior wall MI (IWMI). Subjects and Methods: Fifty-nine patients diagnosed with acute IWMI following RCA revascularization were prospectively investigated between April 2018 and January 2020. Patients were subjected to two-dimensional echocardiography. RV systolic and diastolic functions were reported before and after the PCI procedure and compared using different echocardiographic RV systolic and diastolic parameters. Results: After PCI, echocardiographic RV systolic and diastolic functions were significantly improved in proximal and mid RCA in terms of tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and early RV filling velocity/late RV filling velocity (E/A). Significant improvement was found in mid RCA in terms of peak systolic (S') velocity (P = 0.008) and proximal RCA in terms of early RV filling velocity/early diastolic tricuspid annulus velocity (E/e') (P = 0.021). Overall echocardiographic systolic and diastolic parameters in patients with RV dysfunction following PCI were improved (TAPSE [37.29% vs. 81.82%], S' velocity [37.29% vs. 68.18%], RVFAC [33.90% vs. 90.00%], and E/A [33.90% vs. 75.00%]). Conclusions: Patients with RV dysfunction were remarkably improved after RCA revascularization. Hence, RCA revascularization can become an appropriate treatment alternative for the recovery of patients who suffer from RV dysfunction.