Right ventricular infarction with a culprit lesion in the distal right coronary artery: incidence and clinical characteristics.
- 1Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.
Abstract
Objectives
Right ventricular infarction (RVI) is commonly observed in patients with inferior ST-elevation myocardial infarction and typically results from proximal right coronary artery (RCA) occlusion. However, the occurrence of RVI and its clinical characteristics in patients with distal RCA lesions are not well defined.Methods
We retrospectively investigated 128 patients with inferior ST-elevation myocardial infarction caused by RCA occlusion who underwent primary percutaneous coronary intervention at our institution between January 2020 and December 2023. RVI was diagnosed based on echocardiographic evidence and hemodynamic instability. Clinical characteristics and incidence rates were compared between patients with RVI [the RVI (+) group] and those without RVI [the RVI (-) group]. Findings on coronary angiography were assessed in detail for patients with distal RCA lesions.Results
RVI was identified in 24/128 patients (18.8%), including 3/31 patients (9.7%) with distal RCA lesions. Right ventricular global longitudinal strain (RVGLS) was significantly lower in the RVI (+) group (-14.0% [-16.4, -11.6] vs. -16.4% [-18.7, -13.9]; p=0.004), as was right ventricular free wall strain (RVFWS) (-14.7% [-18.5, -10.6] vs. -17.7% [-20.7, -15.0]; p=0.01). RVGLS and RVFWS values were comparable in the RVI (+) group regardless of whether the RCA lesion was distal or proximal. There was no significant difference in TIMI flow before or after percutaneous coronary intervention or in the distribution of lesions.Conclusions
RVI can be caused by distal RCA lesions, albeit less often than by proximal RCA lesions. No significant differences in RV strain parameters were observed between distal and proximal lesions.
Related
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- Incidence and Implications of Q Waves After Acute ST-Elevation Myocardial Infarction in the Percutaneous Coronary Intervention Era
- Incidence of Periprocedural Myocardial Injury and Infarction After Intravascular Lithotripsy for Calcified Coronary Artery Stenosis
BibTeX
@article{takigawa2026right,
title = {{Right ventricular infarction with a culprit lesion in the distal right coronary artery: incidence and clinical characteristics.}},
author = {Yuki Takigawa and Naoki Hoshino and Meiko Hoshino and Akira Yamada and Masanobu Yanase and Hideo Izawa},
journal = {Fujita medical journal},
year = {2026},
month = sep,
doi = {10.20407/fmj.2025-036},
url = {https://europepmc.org/article/MED/42969008},
note = {CC BY},
}
RIS
TY - JOUR
TI - Right ventricular infarction with a culprit lesion in the distal right coronary artery: incidence and clinical characteristics.
AU - Yuki Takigawa
AU - Naoki Hoshino
AU - Meiko Hoshino
AU - Akira Yamada
AU - Masanobu Yanase
AU - Hideo Izawa
PY - 2026
DA - 2026/09/25
JO - Fujita medical journal
DO - 10.20407/fmj.2025-036
UR - https://europepmc.org/article/MED/42969008
AB - Objectives Right ventricular infarction (RVI) is commonly observed in patients with inferior ST-elevation myocardial infarction and typically results from proximal right coronary artery (RCA) occlusion. However, the occurrence of RVI and its clinical characteristics in patients with distal RCA lesions are not well defined.Methods We retrospectively investigated 128 patients with inferior ST-elevation myocardial infarction caused by RCA occlusion who underwent primary percutaneous coronary intervention at our institution between January 2020 and December 2023. RVI was diagnosed based on echocardiographic evidence and hemodynamic instability. Clinical characteristics and incidence rates were compared between patients with RVI [the RVI (+) group] and those without RVI [the RVI (-) group]. Findings on coronary angiography were assessed in detail for patients with distal RCA lesions.Results RVI was identified in 24/128 patients (18.8%), including 3/31 patients (9.7%) with distal RCA lesions. Right ventricular global longitudinal strain (RVGLS) was significantly lower in the RVI (+) group (-14.0% [-16.4, -11.6] vs. -16.4% [-18.7, -13.9]; p=0.004), as was right ventricular free wall strain (RVFWS) (-14.7% [-18.5, -10.6] vs. -17.7% [-20.7, -15.0]; p=0.01). RVGLS and RVFWS values were comparable in the RVI (+) group regardless of whether the RCA lesion was distal or proximal. There was no significant difference in TIMI flow before or after percutaneous coronary intervention or in the distribution of lesions.Conclusions RVI can be caused by distal RCA lesions, albeit less often than by proximal RCA lesions. No significant differences in RV strain parameters were observed between distal and proximal lesions.
SN - 2189-7247
SN - 2189-7255
ER -