Coronary artery diseaseUsefulness of Right Ventricular Fractional Area Change to Predict Death, Heart Failure, and Stroke Following Myocardial Infarction (from the VALIANT ECHO Study)
Section snippets
Methods
VALIANT was a multinational, double-blind, randomized, active-controlled study of 14,703 patients with 3 parallel treatment groups comparing the efficacy and safety of long-term treatment with valsartan, captopril, and their combination within 12 hours to 10 days after acute MI in patients with acute HF, left ventricular systolic dysfunction, or both.1 Inclusion and exclusion criteria and details of patient characteristics were previously described. Clinical sites participating in the main
Results
Baseline RVFAC for 522 patients was approximately symmetrically distributed (mean RVFAC 41.9 ± 4.3%; Figure 1). Across RVFAC categories (Table 1), there were no differences with respect to age, gender, pulmonary disease, smoking, hemodynamic variables, Killip’s classification, medications, or infarct location. Individuals in the lowest RVFAC category had a higher incidence of hypertension, previous MI, previous congestive HF, a higher proportion of non–Q-wave MIs, larger left ventricular
Discussion
In this analysis, baseline right ventricular function assessed using RVFAC was found to be a significant independent predictor for a broad spectrum of CV outcomes in patients with left ventricular dysfunction and/or HF complicating MI. These results confirmed the importance of right ventricular function after infarction and argue for routine assessment of right ventricular function in high-risk patients.
The concept that impaired right ventricular function after MI was associated with poor
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