Author + information
- Received January 17, 1983
- Revision received May 16, 1983
- Accepted May 18, 1983
- Published online October 1, 1983.
- ↵1Address for reprints: Pravin M. Shah, MD, Cardiology (691/1 HE), Wadsworth Veterans Administration Medical Center, Wilshire and Sawtelle Boulevards, Los Angeles, California 90073.
To assess the chronic effects of myocardial infarction on right ventricular function, 48 subjects were studied utilizing radionuclide angiography and two-dimensional echocardiography. Ten were normal subjects (group I), 11 had previous inferior wall myocardial infarction (group II), 10 had previous anteroseptal infarction (group III), 11 had combined anteroseptal and inferior infarction (group IV) and 6 had extensive anterolateral infarction (group V).
The mean (± standard deviation) left ventricular ejection fraction was 0.66 ± 0.03 in group I, 0.58 ± 0.02 in group II, 0.52 ± 0.02 in group III, 0.33 ± 0.03 in group IV and 0.33 ± 0.01 in group V. No systematic correlation between left and right ventricular ejection fraction was observed among the groups. The mean right ventricular ejection fraction was significantly reduced in the presence of inferior myocardial infarction (0.30 ± 0.03 in group II and 0.29 ± 0.03 in group IV compared with 0.43 ± 0.02 in group I [p < 0.001]). The group II and IV patients also had increased (p < 0.001) right ventricular end-diastolic area and decreased (p < 0.001) right ventricular free wall motion by two-dimensional echocardiography. In the presence of anteroseptal infarction (group III), right ventricular free wall motion was increased (p < 0.05) compared with normal subjects (group I).
Thus, the effects of prior myocardial infarction on right ventricular function depend more on the location of infarction than on the extent of left ventricular dysfunction. Inferior infarction was commonly associated with reduced right ventricular ejection fraction and increased right ventricular end-diastolic area. The right ventricular free wall excursion was increased in the presence of anteroseptal infarction, suggesting loss of contribution of interventricular septal contraction to right ventricular ejection.
↵* Current address: Cardiac Unit, Massachusetts General Hospital, Boston, Massachusetts 02114.
This study was supported in part by the Arthur Dodd Fuller Foundation for Cardiovascular Research, Los Angeles, California and Veterans Administration Medical research funds.
- Received January 17, 1983.
- Revision received May 16, 1983.
- Accepted May 18, 1983.
- American College of Cardiology Foundation