Sao Paulo Medical Journal
On-line version ISSN 1806-9460
PEREIRA, Afonso Celso; FRANKEN, Roberto Alexandre; SPROVIERI, Sandra Regina Schwarzwälder and GOLIN, Valdir. Impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular infarction. Sao Paulo Med. J. [online]. 2006, vol.124, n.4, pp. 186-191. ISSN 1806-9460. http://dx.doi.org/10.1590/S1516-31802006000400003.
CONTEXT AND OBJECTIVE: 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. DESIGN AND SETTING: Prospective cohort study, at Emergency Care Unit of Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo. METHODS: 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. RESULTS: 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. CONCLUSIONS: Patients with LV infarction with RV involvement present increased risk of early morbidity and mortality.
Keywords : Myocardial infarction; Heart ventricles; Right ventricular dysfunction; Hospital mortality; Morbidity.