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dc.contributor.authorAnavekar, Nagesh Sen
dc.contributor.authorSkali, Hichamen
dc.contributor.authorBourgoun, Mikhailen
dc.contributor.authorGhali, Jalal Ken
dc.contributor.authorKober, Larsen
dc.contributor.authorMaggioni, Aldo Pen
dc.contributor.authorMcMurray, John J Ven
dc.contributor.authorVelazquez, Ericen
dc.contributor.authorCaliff, Roberten
dc.contributor.authorPfeffer, Marc Aen
dc.contributor.authorSolomon, Scott Den
dc.identifier.citationThe American Journal of Cardiology; 101(5): 607-12en
dc.description.abstractSevere right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after MI was less clear. Two-dimensional echocardiograms were obtained in 605 patients with left ventricular dysfunction and/or clinical/radiologic evidence of HF from the VALIANT echocardiographic substudy (mean 5.0 +/- 2.5 days after MI). Clinical outcomes included all-cause mortality, cardiovascular (CV) death, sudden death, HF, and stroke. Baseline right ventricular function was measured in 522 patients using right ventricular fractional area change (RVFAC) and was related to clinical outcomes. Mean RVFAC was 41.9 +/- 4.3% (range 19.2% to 53.1%). The incidence of clinical events increased with decreasing RVFAC. After adjusting for 11 covariates, including age, ejection fraction, and Killip's classification, decreased RVFAC was independently associated with increased risk of all-cause mortality (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.31 to 1.98), CV death (HR 1.62, 95% CI 1.30 to 2.01), sudden death (HR 1.79, 95% CI 1.26 to 2.54), HF (HR 1.48, 95% CI 1.17 to 1.86), and stroke (HR 2.95, 95% CI 1.76 to 4.95), but not recurrent MI. Each 5% decrease in baseline RVFAC was associated with a 1.53 (95% CI 1.24 to 1.88) increased risk of fatal and nonfatal CV outcomes. In conclusion, decreased right ventricular systolic function is a major risk factor for death, sudden death, HF, and stroke after MI.en
dc.subject.otherDeath, Suddenen
dc.subject.otherDouble-Blind Methoden
dc.subject.otherFollow-Up Studiesen
dc.subject.otherHeart Failure.epidemiology.physiopathologyen
dc.subject.otherHeart Ventricles.ultrasonographyen
dc.subject.otherMiddle Ageden
dc.subject.otherMyocardial Infarction.epidemiology.physiopathologyen
dc.subject.otherOutcome Assessment (Health Care)en
dc.subject.otherStroke Volume.physiologyen
dc.subject.otherVentricular Dysfunction, Left.epidemiology.physiopathologyen
dc.subject.otherVentricular Dysfunction, Right.epidemiology.physiopathologyen
dc.titleUsefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study).en
dc.typeJournal Articleen
dc.identifier.journaltitleThe American journal of cardiologyen
dc.identifier.affiliationDepartment of Cardiology, Austin Health, University of Melbourne, Melbourne, Australiaen
dc.type.austinJournal Articleen
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
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