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Updated: Aug 31, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Prognostic implications of right atrial ischemic dysfunction in patients with biventricular inferior infarction:
J Vargas-Barron1, J Roldan, N Espinola-Zavaleta
1Department of Echocardiography, Instituto Nacional de Cardiología "Ignacio Chávez," Juan Badiano No. 1, Tlalpan, 14080 México, D.F., Mexico.
Insights
Transesophageal echocardiography (TEE) safely assesses right atrial dysfunction following inferior myocardial infarction. Findings reveal TEE
Area of Science:
- Cardiology
- Echocardiography
- Clinical Outcomes
Background:
- Inferior myocardial infarction can extend to the right ventricle and atrium.
- Right atrial dysfunction's impact on clinical outcomes requires further investigation.
Purpose of the Study:
- To determine the effect of right atrial dysfunction on clinical outcomes in patients with inferior myocardial infarction.
- To evaluate the safety and efficacy of transesophageal echocardiography (TEE) in assessing right heart involvement.
Main Methods:
- Six patients with inferior myocardial infarction and right heart involvement underwent TEE.
- Follow-up TEE examinations were performed on five patients 15 to 55 months later.
- Clinical outcomes, including mortality and echocardiographic parameters, were analyzed.
Main Results:
- Two patients treated with thrombolysis showed favorable right-to-left ventricular ratios and normal interatrial septum convexity.
- One patient with spontaneous reperfusion demonstrated reduced right ventricular diameter and normalized interatrial septum.
- Two patients died, one during hospitalization and one during follow-up, both exhibiting right ventricular dilatation and abnormal interatrial septum morphology.
Conclusions:
- Serial TEE is a safe and effective method for assessing the extent of myocardial infarction to the right heart chambers.
- Right atrial dysfunction and right ventricular dilatation are associated with adverse clinical outcomes, including mortality.
- Early detection and management of right heart involvement in myocardial infarction may improve patient prognosis.
Abstract:
In order to determine the effect of right atrial dysfunction on clinical outcome, six patients with inferior myocardial infarction with extension to right ventricle and right atrium involving only obstructions of the right coronary artery were examined with transesophageal echocardiography (TEE) at the time of the event. Five of the patients were reexamined 15 to 55 months later. Two patients underwent thrombolysis and maintained ratios of right-to-left ventricular diameters of less than 1, as well as normal convexity of the interatrial septum. One patient had spontaneous reperfusion of the right coronary artery, reduction in right ventricular diameter, and normalization of interatrial septum. Another patient underwent delayed angioplasty and manifested a diminished wall movement score (WMS) in the follow-up echocardiogram. One patient died during his first hospitalization with significant right ventricular dilatation, inverted convexity of the interatrial septum, and right atrial thrombosis. The last patient died during follow-up with right ventricular dilatation, increased WMS, right atrial akinesis, and inverted interatrial convexity. Serial TEE examination of patients with infarction of the left ventricular inferior wall is a safe technique for determining the degree of the extension of the ischemic process to the right chambers.
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