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Utility of cardiac magnetic resonance (CMR) in the evaluation of right ventricular (RV) involvement in patients with myocardial infarction (MI)

  • Cardiac Radiology
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Abstract

Purpose

The aim of this work was to compare the prevalence of right ventricle involvement in a population of patients with myocardial infarction as detected by cardiac magnetic resonance (CMR), clinical presentation, electrocardiographic (ECG) and echocardiographic criteria.

Materials and methods

A total of 97 consecutive patients, admitted to our institution for acute myocardial infarction, underwent a standard CMR examination within 5 days after the event. The presence of myocardial oedema and late enhancement of the right ventricle were compared to infarct location (anterior vs. inferior), clinical data, ECG, echocardiography results and other CMR findings. The results were analysed statistically using the Student’s t test for independent samples and the K statistic.

Results

Among the 97 patients included in the study, a diagnosis of right ventricular infarction was established in 12, 14 and 24 cases on the basis of the clinical data, the ECG and echocardiography, respectively. CMR demonstrated myocardial oedema and late enhancement of the right ventricle in 48 and 32 cases, respectively. The right ventricle was involved in 46 % of patients with inferior myocardial infarction (15/32) and in 30 % with anterior myocardial infarction (17/56), correlating to a worsening of both right and left ventricular performance (p = 0.001–0.05).

Conclusions

The right ventricle is frequently involved in myocardial infarction, correlating to a worse functional impairment of both ventricles and a worse prognosis. This finding, which is often underestimated by traditional cardiological tests, is well revealed by CMR, with potential clinical and therapeutic impact.

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Conflict of interest

Nicola Galea, Marco Francone, Iacopo Carbone, David Cannata, Francesco Vullo, Roberto Galea, Luciano Agati, Francesco Fedele, Carlo Catalano declare no conflict of interest.

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Authors and Affiliations

  1. Dipartmento di Scienze Radiologiche, Oncologiche ed Anatomo-patologiche, Policlinico Umberto I, Università di Roma “Sapienza”, Viale Regina Elena 324, 00161, Rome, Italy

    Nicola Galea, Marco Francone, Iacopo Carbone, David Cannata, Francesco Vullo & Carlo Catalano

  2. Dipartimento di Scienze Cardiovascolari e Respiratorie, Policlinico Umberto I, Università di Roma “Sapienza”, Viale Regina Elena 324, 00161, Rome, Italy

    Luciano Agati & Francesco Fedele

  3. UOC Malattie Cardiovascolari, Fondazione IRCSS Ospedale Maggiore Policlinico Università degli Studi di Milano, Via Francesco Sforza 35, 20122, Milan, Italy

    Roberto Galea

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  1. Nicola Galea
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  2. Marco Francone
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  3. Iacopo Carbone
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  6. Roberto Galea
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  8. Francesco Fedele
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  9. Carlo Catalano
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Correspondence to Nicola Galea.

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Galea, N., Francone, M., Carbone, I. et al. Utility of cardiac magnetic resonance (CMR) in the evaluation of right ventricular (RV) involvement in patients with myocardial infarction (MI). Radiol med 119, 309–317 (2014). https://doi.org/10.1007/s11547-013-0341-4

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  • DOI: https://doi.org/10.1007/s11547-013-0341-4

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