Rapid hemodynamic improvement after reperfusion during right XXXX .

@entity1 @entity583 @entity1188
OBJECTIVES: This study sought to determine the effects of reperfusion on hemodynamic status and hospital course in @entity1 with right @entity1188 . BACKGROUND: In contrast to the relatively low risk associated with acute @entity583 , right @entity1188 is associated with higher in-hospital morbidity and mortality. However, the potential benefits of reperfusion in @entity1 with right @entity1188 are unknown. Consequently, this study evaluated the potential benefits of primary angioplasty in @entity1 with right @entity1188 . METHODS: Of 141 consecutive @entity1 admitted to the hospital for @entity583 , 27 were identified as having right ventricular involvement by electrocardiographic and hemodynamic criteria. Seventeen @entity1 achieved patency of the @entity1188 -related right coronary artery by primary coronary angioplasty within 24 h of hospital admission, but 10 @entity1 did not. All @entity1 had invasive hemodynamic monitoring at the time of hospital admission, and subsequent serial hemodynamic status and clinical events were recorded. RESULTS: @entity1 with successful reperfusion demonstrated improved right atrial pressure, pulmonary capillary wedge pressure and right atrial/pulmonary capillary wedge pressure ratio as early as 8 h after reperfusion, whereas @entity1 without reperfusion had no hemodynamic improvement over 24 h. Right atrial pressure demonstrated the greatest 8-h improvement after successful reperfusion (15.4 +/- 0.8 to 8.4 +/- 0.8 mm Hg [mean +/- SD], p < 0.05) but was unchanged without reperfusion (13.7 +/- 0.9 to 13.9 +/- 0.8 mm Hg, p = NS). Additionally, persistently elevated right atrial pressure was associated with increased mortality. CONCLUSIONS: Reperfusion in the setting of right @entity1188 leads to rapid hemodynamic improvement and may result in improved survival.
