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

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Abstract

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.

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References

  1. Assali AR, Teplitsky I, Ben-Dor I, Solodky A, Brosh D, Battler A, Fuchs S, Kornowski R (2007) Prognostic importance of right ventricular infarction in an acute myocardial infarction cohort referred for contemporary percutaneous reperfusion therapy. Am Heart J 153:231–237. https://doi.org/10.1016/j.ahj.2006.10.038

    Article  PubMed  Google Scholar 

  2. Maeder MT, Holst DP, Kaye DM (2008) Tricuspid regurgitation contributes to renal dysfunction in patients with heart failure. J Card Fail 14:824–830. https://doi.org/10.1016/j.cardfail.2008.07.236

    Article  PubMed  Google Scholar 

  3. Mielniczuk LM, Chandy G, Stewart D, Contreras-Dominguez V, Haddad H, Pugliese C, Davies RA (2012) Worsening renal function and prognosis in pulmonary hypertension patients hospitalized for right heart failure. Congest Heart Fail 18:151–157. https://doi.org/10.1111/j.1751-7133.2011.00275.x

    Article  CAS  PubMed  Google Scholar 

  4. Firth JD, Raine AE, Ledingham JG (1988) Raised venous pressure: a direct cause of renal sodium retention in oedema? Lancet 1:1033–1035. https://doi.org/10.1016/S0140-6736(88)91851-X

    Article  CAS  PubMed  Google Scholar 

  5. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. Eur Heart J Cardiovasc Imaging 16:233–271. https://doi.org/10.1093/ehjci/jev014

    Article  PubMed  Google Scholar 

  6. Carlsson M, Ugander M, Heiberg E, Arheden H (2007) The quantitative relationship between longitudinal and radial function in left, right, and total heart pumping in humans. Am J Physiol Heart Circ Physiol 293:H636–H644. https://doi.org/10.1152/ajpheart.01376.2006

    Article  CAS  PubMed  Google Scholar 

  7. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Katus HA, Apple FS, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow JJ, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand J-P, Menasche P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon J-L, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Torbicki A, Vahanian A, Windecker S, Morais J, Aguiar C, Almahmeed W, Arnar DO, Barili F, Bloch KD, Bolger AF, Botker HE, Bozkurt B, Bugiardini R, Cannon C, de Lemos J, Eberli FR, Escobar E, Hlatky M, James S, Kern KB, Moliterno DJ, Mueller C, Neskovic AN, Pieske BM, Schulman SP, Storey RF, Taubert KA, Vranckx P, Wagner DR (2012) Third universal definition of myocardial infarction. J Am Coll Cardiol 60:1581–1598. https://doi.org/10.1016/j.jacc.2012.08.001

    Article  PubMed  Google Scholar 

  8. Ivey-Miranda JB, Posada-Martínez EL, Almeida-Gutiérrez E, Borrayo-Sánchez G, Flores-Umanzor E (2018) Right atrial pressure predicts worsening renal function in patients with acute right ventricular myocardial infarction. Int J Cardiol. https://doi.org/10.1016/J.IJCARD.2017.12.087

    Article  PubMed  Google Scholar 

  9. Khwaja A (2012) KDIGO clinical practice guidelines for acute kidney injury. Kidney Int Suppl 1–138

  10. Testani JM, Khera AV, St MG. John Sutton MG, Keane SE, Wiegers RP, Shannon JN, Kirkpatrick (2010) Effect of right ventricular function and venous congestion on cardiorenal interactions during the treatment of decompensated heart failure. Am J Cardiol 105:511–516. https://doi.org/10.1016/j.amjcard.2009.10.020

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tandon R, Mohan B, Chhabra ST, Aslam N, Wander GS (2013) Clinical and echocardiographic predictors of cardiorenal syndrome type I in patients with acute ischemic right ventricular dysfunction. Cardiorenal Med 3:239–245. https://doi.org/10.1159/000355524

    Article  PubMed  PubMed Central  Google Scholar 

  12. Park SJ, Park J-H, Lee HS, Kim MS, Park YK, Park Y, Kim YJ, Lee J-H, Choi S-W, Jeong J-O, Kwon IS, Seong I-W (2015) Impaired RV global longitudinal strain is associated with poor long-term clinical outcomes in patients with acute inferior STEMI. JACC: Cardiovasc Imaging 8:161–169. https://doi.org/10.1016/j.jcmg.2014.10.011

    Article  Google Scholar 

  13. Pencina MJ, D’Agostino RB, D’Agostino RB, Vasan RS (2008) Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med 27:157–172. https://doi.org/10.1002/sim.2929 discussion 207–212

    Article  PubMed  Google Scholar 

  14. Ivey-Miranda JB, Posada-Martínez EL, Almeida-Gutierrez E, Flores-Umanzor E, Borrayo-Sanchez G, Saturno-Chiu G (2017) Assessment of right atrial pressure with two-dimensional, Doppler and speckle tracking echocardiography in patients with acute right ventricular myocardial infarction. Med Intensiva. https://doi.org/10.1016/j.medin.2017.10.009

    Article  PubMed  Google Scholar 

  15. Dhillon A, Sweet W, Popovic ZB, Smedira NG, Thamilarasan M, Lytle BW, Tan C, Starling RC, Lever HM, Moravec CS, Desai MY (2014) Association of noninvasively measured left ventricular mechanics with in vitro muscle contractile performance: a prospective study in hypertrophic cardiomyopathy patients. J Am Heart Assoc 3:e001269. https://doi.org/10.1161/JAHA.114.001269

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gecmen C, Candan O, Kahyaoglu M, Kalayci A, Cakmak EO, Karaduman A, Izgi IA, Kirma C (2018) Echocardiographic assessment of right ventricle free wall strain for prediction of right coronary artery proximal lesion in patients with inferior myocardial infarction, Int J Cardiovasc Imaging. https://doi.org/10.1007/s10554-018-1325-1

    Article  PubMed  Google Scholar 

  17. Shacham Y, Leshem-Rubinow E, Gal-Oz A, Arbel Y, Keren G, Roth A, Steinvil A (2014) Relation of time to coronary reperfusion and the development of acute kidney injury after ST-segment elevation myocardial infarction. Am J Cardiol 114:1131–1135. https://doi.org/10.1016/j.amjcard.2014.07.032

    Article  PubMed  Google Scholar 

  18. Belziti CA, Bagnati R, Ledesma P, Vulcano N, Fernández S (2010) Worsening renal function in patients admitted with acute decompensated heart failure: incidence, risk factors and prognostic implications. Rev Española Cardiol 63:294–302

    Article  Google Scholar 

  19. Cowie MR, Komajda M, Murray-Thomas T, Underwood J, Ticho B (2006) Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH). Eur Heart J 27:1216–1222. https://doi.org/10.1093/eurheartj/ehi859

    Article  PubMed  Google Scholar 

  20. Lemarié J, Huttin O, Girerd N, Mandry D, Juillière Y, Moulin F, Lemoine S, Beaumont M, Marie P-Y, Selton-Suty C (2015) Usefulness of speckle-tracking imaging for right ventricular assessment after acute myocardial infarction: a magnetic resonance imaging/echocardiographic comparison within the relation between aldosterone and cardiac remodeling after myocardial infarction. J Am Soc Echocardiogr 28:818–827.e4. https://doi.org/10.1016/j.echo.2015.02.019

    Article  PubMed  Google Scholar 

  21. Jurcut R, Pappas CJ, Masci PG, Herbots L, Szulik M, Bogaert J, Van de Werf F, Desmet W, Rademakers F, Voigt J-U, D’hooge J (2008) Detection of regional myocardial dysfunction in patients with acute myocardial infarction using velocity vector imaging. J Am Soc Echocardiogr 21:879–886. https://doi.org/10.1016/j.echo.2008.02.002

    Article  PubMed  Google Scholar 

  22. Huttin O, Lemarié J, Di Meglio M, Girerd N, Mandry D, Moulin F, Lemoine S, Juillière Y, Felblinger J, Marie P-Y, Selton-Suty C (2015) Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography. Int J Cardiovasc Imaging 31:537–545. https://doi.org/10.1007/s10554-014-0585-7

    Article  PubMed  Google Scholar 

  23. Hutyra M, Skála T, Horák D, Köcher M, Tüdös Z, Zapletalová J, Přeček J, Louis A, Smékal A, Táborský M (2015) Echocardiographic assessment of global longitudinal right ventricular function in patients with an acute inferior ST elevation myocardial infarction and proximal right coronary artery occlusion. Int J Cardiovasc Imaging 31:497–507. https://doi.org/10.1007/s10554-014-0573-y

    Article  PubMed  Google Scholar 

  24. Shacham Y, Leshem-Rubinow E, Gal-Oz A, Topilsky Y, Steinvil A, Keren G, Roth A, Arbel Y (2015) Association of left ventricular function and acute kidney injury among ST-elevation myocardial infarction patients treated by primary percutaneous intervention. Am J Cardiol 115:293–297. https://doi.org/10.1016/j.amjcard.2014.11.002

    Article  PubMed  Google Scholar 

  25. Smarz K, Zaborska B, Jaxa-Chamiec T, Tysarowski M, Budaj A (2016) Right ventricular systolic function as a marker of prognosis after ST-elevation inferior myocardial infarction 5-year follow-up. Int J Cardiol 221:549–553. https://doi.org/10.1016/j.ijcard.2016.07.088

    Article  PubMed  Google Scholar 

  26. Kanar BG, Tigen MK, Sunbul M, Cincin A, Atas H, Kepez A, Ozben B (2018) The impact of right ventricular function assessed by 2-dimensional speckle tracking echocardiography on early mortality in patients with inferior myocardial infarction. Clin Cardiol 41:413–418. https://doi.org/10.1002/clc.22890

    Article  PubMed  Google Scholar 

  27. Gopalakrishnan A, Sanjay G, Nair KKM, Harikrishnan S, Valaparambil A (2016) Deleterious effects of isolated right ventricular pacing in right ventricular myocardial infarction. Int J Cardiol 222:995–996. https://doi.org/10.1016/j.ijcard.2016.08.015

    Article  PubMed  Google Scholar 

  28. Gorter TM, Lexis CPH, Hummel YM, Lipsic E, Nijveldt R, Willems TP, van der Horst ICC, van der Harst P, van Melle JP, van Veldhuisen DJ (2016) Right ventricular function after acute myocardial infarction treated with primary percutaneous coronary intervention (from the glycometabolic intervention as adjunct to primary percutaneous coronary intervention in st-segment elevation myocardial infarction III trial). Am J Cardiol 118:338–344. https://doi.org/10.1016/j.amjcard.2016.05.006

    Article  PubMed  Google Scholar 

  29. Vitarelli A, Mangieri E, Terzano C, Gaudio C, Salsano F, Rosato E, Capotosto L, D’Orazio S, Azzano A, Truscelli G, Cocco N, Ashurov R (2015) Three-dimensional echocardiography and 2D-3D speckle-tracking imaging in chronic pulmonary hypertension: diagnostic accuracy in detecting hemodynamic signs of right ventricular (RV) failure. J Am Heart Assoc 4:e001584. https://doi.org/10.1161/JAHA.114.001584

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

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

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Authors and Affiliations

  1. Department of Acute Cardiovascular Care, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Juan Betuel Ivey-Miranda, Javier Antezana-Castro, Edith González-Morales & Nayeli García-Hernández

  2. Department of Research, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Eduardo Almeida-Gutiérrez

  3. Department of Medical Direction and Research, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Gabriela Borrayo-Sánchez & Guillermo Saturno-Chiu

  4. Department of Echocardiography, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Alicia Contreras-Rodríguez & Diana Romero-Zertuche

  5. Department of Echocardiography, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico

    Edith Liliana Posada-Martínez

  6. Department of Congenital Heart Disease, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Horacio Marquez-Gonzalez

  7. Department of Research, Hospital Infantil de Mexico, Mexico City, Mexico

    Horacio Marquez-Gonzalez

Authors
  1. Juan Betuel Ivey-Miranda
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  2. Eduardo Almeida-Gutiérrez
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  3. Gabriela Borrayo-Sánchez
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  6. Edith Liliana Posada-Martínez
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  7. Edith González-Morales
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  8. Nayeli García-Hernández
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  10. Horacio Marquez-Gonzalez
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  11. Guillermo Saturno-Chiu
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Correspondence to Eduardo Almeida-Gutiérrez.

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Ivey-Miranda, J.B., Almeida-Gutiérrez, E., Borrayo-Sánchez, G. et al. Right ventricular longitudinal strain predicts acute kidney injury and short-term prognosis in patients with right ventricular myocardial infarction. Int J Cardiovasc Imaging 35, 107–116 (2019). https://doi.org/10.1007/s10554-018-1447-5

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