Impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular infarction

• Published in: São Paulo medical journal 2006, Vol.124 (4), p.186-191
• Main Authors: Pereira, Afonso Celso, Franken, Roberto Alexandre, Sprovieri, Sandra Regina Schwarzwälder, Golin, Valdir
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brazil - epidemiology; Epidemiologic Methods; Female; Fibrinolytic Agents - therapeutic use; Heart Ventricles; Hospital Mortality; Humans; Length of Stay; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Morbidity; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Right ventricular dysfunction; Severity of Illness Index; Time Factors
• ISSN: 1516-3180; 1806-9460; 1516-3180
• DOI: 10.1590/s1516-31802006000400003

There is uncertainty regarding the risk of major complications in patients with left ventricular (LV) infarction complicated by right ventricular (RV) involvement. The aim of this study was to evaluate the impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular myocardial infarction. Prospective cohort study, at Emergency Care Unit of Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo. 183 patients with acute myocardial infarction participated in this study: 145 with LV infarction alone and 38 with both LV and RV infarction. The presence of complications and hospital death were compared between groups. 21% of the patients studied had LV + RV infarction. In this group, involvement of the dorsal and/or inferior wall was predominant on electrocardiogram (p < 0.0001). The frequencies of Killip class IV upon admission and 24 hours later were greater in the LV + RV group, along with electrical and hemodynamic complications, among others, and death. The probability of complications among the LV + RV patients was 9.7 times greater (odds ratio, OR = 9.7468; 95% confidence interval, CI: 2.8673 to 33.1325; p < 0.0001) and probability of death was 5.1 times greater (OR = 5.13; 95% CI: 2.2795 to 11.5510; p = 0.0001), in relation to patients with LV infarction alone. Patients with LV infarction with RV involvement present increased risk of early morbidity and mortality.