Right ventricular longitudinal strain predicts acute kidney injury and short-term prognosis in patients with right ventricular myocardial infarction

  • Juan Betuel Ivey-Miranda
  • Eduardo Almeida-GutiérrezEmail author
  • Gabriela Borrayo-Sánchez
  • Javier Antezana-Castro
  • Alicia Contreras-Rodríguez
  • Edith Liliana Posada-Martínez
  • Edith González-Morales
  • Nayeli García-Hernández
  • Diana Romero-Zertuche
  • Horacio Marquez-Gonzalez
  • Guillermo Saturno-Chiu
Original Paper


Right ventricular (RV) systolic dysfunction due to acute myocardial infarction is associated with serious complications in the short-term. Acute kidney injury (AKI) is a frequent and unrecognized complication. This study aimed to assess whether RV longitudinal strain predicts AKI and short-term prognosis in patients with RV infarction. Prospective cohort of patients with RV infarction. RV function was evaluated with global and free wall right ventricular longitudinal strain (GRVLS and FWRVLS), tricuspid annular plane systolic excursion, and tricuspid S′ wave. The primary endpoint was AKI defined as an increase ≥ 50% in serum creatinine and/or a decrease ≥ 25% in glomerular filtration rate during follow-up at 7 days. The secondary endpoint was death from any cause at 30 days. We included 101 patients with RV infarction (male 67%, age 66 ± 11 years). During follow-up at 7 days, 40% of patients developed AKI. At 30 days, 8% of patients died. At univariate analysis, FWRVLS was significantly associated with AKI (Hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.03–1.20, p = 0.006). At multivariate analysis, only age, temporary pacemaker implant, and FWRVLS remained as independent predictors of AKI (HR 1.05, 95% CI 1.02–1.08, p = 0.002; HR 2.12, 95% CI 1.11–4.07, p = 0.023; HR 1.10, 95% CI 1.02–1.19, p = 0.018, respectively). At 30 days, patients with FWRVLS ≥ − 15.5% showed a lower survival rate than those with lower strain (84 ± 6 vs. 97 ± 2%, p = 0.021). In patients with RV infarction, FWRVLS was an independent predictor of AKI and was associated with higher mortality in the short-term.


Ventricular dysfunction Right Myocardial infarction Acute kidney Injury Echocardiography 



Dr Ivey-Miranda received a grant from “Comisión Nacional de Ciencia y Tecnología” (Mexico City, Mexico) to support this study.

Compliance with ethical standards

Conflict of interest

We report that we have no relationships to disclose, relevant to the contents of this paper.

Supplementary material

10554_2018_1447_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 21 KB)


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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Juan Betuel Ivey-Miranda
    • 1
  • Eduardo Almeida-Gutiérrez
    • 2
    Email author
  • Gabriela Borrayo-Sánchez
    • 3
  • Javier Antezana-Castro
    • 1
  • Alicia Contreras-Rodríguez
    • 4
  • Edith Liliana Posada-Martínez
    • 5
  • Edith González-Morales
    • 1
  • Nayeli García-Hernández
    • 1
  • Diana Romero-Zertuche
    • 4
  • Horacio Marquez-Gonzalez
    • 6
    • 7
  • Guillermo Saturno-Chiu
    • 3
  1. 1.Department of Acute Cardiovascular Care, Hospital de Cardiología, Centro Médico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
  2. 2.Department of Research, Hospital de Cardiología, Centro Médico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
  3. 3.Department of Medical Direction and Research, Hospital de Cardiología, Centro Médico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
  4. 4.Department of Echocardiography, Hospital de Cardiología, Centro Médico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
  5. 5.Department of EchocardiographyInstituto Nacional de Cardiología Ignacio ChavezMexico CityMexico
  6. 6.Department of Congenital Heart Disease, Hospital de Cardiología, Centro Médico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
  7. 7.Department of ResearchHospital Infantil de MexicoMexico CityMexico

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