[Right and left ventricular function and incidence of major complications in acute inferior myocardial infarct. Study by equilibrium-gated radioisotope angiography].

By means of equilibrium gated radionuclide angiography (EGRA) 67 patients were studied with first inferior acute myocardial infarction (AMI) within 4 days of the onset of symptoms and 12 normal volunteers. Ejection fraction (EF) of the left ventricle (LV) and right ventricle (RV) was computed. The regional wall motion (RWM) was evaluated by parametric images of amplitude and phase (Fourier analysis). The following major in-hospital complications were diagnosed in 41 patients (61%): postinfarction angina, congestive heart failure (CHF), high-degree atrioventricular (AV) block, ventricular tachycardia or ventricular fibrillation, shock, extension of infarction, pericarditis, pulmonary embolism and acute pulmonary edema. A significant correlation between RVEF and the extent of RVRWM abnormalities and the incidence of major complications was found. In particular, the incidence of shock and CHF was significantly correlated with that of the RV disfunction, while the LVEF was generally in the normal range despite a high incidence of LVRWM abnormalities. In the patients developing high-degree AV block this correlation did not reach statistical significance; in this group, 10 of 12 patients developed other major complications. Also in 10 of 13 cases with CHF, other complications arose during the period of hospitalization. In conclusion the disfunction of the RV can identify the subgroup of patients with inferior AMI who are at high risk for developing major complications, especially shock and CHF. AV block and CHF have a severe prognostic meaning, because they occur usually in association with other major complications.