Three-dimensional Echocardiographic Assessment Of Right Ventricular Function And Its Long-term Prognosis In Right Heart Failure After Myocardial Infarction

Aim: The purpose of this study was to assess RV(right ventricular)function in right heart failure after myocardial infarction complicated with left heart failure and long-term prognosis.Methods: 60 patients were enrolled during 2012-2016 in the People's Hospital of Liaoning Province.Study group collected patients with right heart failure(n=30)after MI complicated with left heart failure,the enrollment standard was coronary angiography(CAG)confirmation,Electrocardiogram showed as Q wave,NT-pro-BNP?1800ng/L,left ventricular ejection fraction ?35% which was measured by Echocardiography,and infarction wall movement was assessed as hypokinesis,akinesis,or dyskinesis.Pulmonary arterial hypertension was existed.NYHA classification was between ?-?.The patients had clinical symptoms and signs of right heart failure;Control group collected patients without right heart failure(n=30)after MI complicated with left heart failure.The enrollment was confirmed with CAG,Electrocardiogram with wave Q,NT-pro-BNP ?1800ng/L,left ventricular ejection fraction ?35% which was measured by Echocardiography and infarction wall movement was assessed as hypokinesis,akinesis or dyskinesis.No Pulmonary arterial hypertension.NYHA classification was between ?-?.No clinical symptoms and signs of right heartfailure exist.Exclusion criteria include congenital heart disease,Valvular disease,Hyperthyroid cardiomyopathy,Amyloid cardiomyopathy,pulmonary heart disease or other reasons lead to heart failure.Atrial fibrillation and other serious arrhythmia was excluded.Poor acoustic condition which cannot grantee the image quality was also excluded.Evaluation of LVEF,RVEDV,RVESV,RVSV and RVEF for the first time(M0),six months(M6),18 months(M18),36 months(M36)after enrollment were collected by using SIMENS ACUSON SC2000 echocardiogram.Result: Comparison general situation of the two groups: The differences between groups had no statistically significant of sex,age,hypertension,diabetes,smoking history and therapies(p>0.05).Comparsion Echocardiography index of the two groups:The differences between the two groups had statistically significant of LVEF,RVEDV,RVESV,RVSV,RVEF(p<0.05);During 36 months follow-up,LVEF had statistically significant in M36 compared with the first three times in control group(p<0.05).RVEDV,RVESV,RVSV,RVEF had no statistically significant in control group(p<0.05);36months follow-up,LVEF had statistically significant in M36 compared with the first three times in trial group(p<0.05).LVEF had statistically significant in M18 compared with the first two times in trial group(p<0.05).RVEDV,RVESV had statistically significant in M36 compared with the first three times in trial group(p<0.05).RVSV had statistically significant in M36 compared with the first three times in trial group(p<0.05),and also had statistically significant in M18 compared with the first two times.RVEF had statistically significant in M36 compared with the first three times in trial group(p<0.05),and also had statistically significant in M18 compared with the first two times in trial group(p<0.05).Conclusion: the heavier left heart failure after myocardial MI,the greater impact on right ventricular function;Right heart failure after MI complicated with left heart failure after long-term follow-up,right ventricular function will declined gradually.Right heart failure have poor prognosis.