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Impedance Cardiographic Findings in Electrocardiographically Diagnosed Acute Right Ventricular Infarction
Authors:Hasan Fehmi Tore  Mehmet Uzun  Kursad Erinc  Ata Kirilmaz  Cem Barcin  Oben Baysan  Nadir Barindik  Ertan Demirtas
Abstract:
Background: Thorax impedance cardiography (TIC) can provide important information about the hemodynamic state of patients. In this study, we aimed at finding out if TIC can be used in the early follow‐up of acute right ventricular myocardial infarction (RVMI). Methods: The study consisted of patients with RVMI who were admitted to our coronary care unit between March 1998 and October 1999. The patients were divided into two groups: group A: patients with hemodynamically significant RVMI, and group B: patients with hemodynamically insignificant RVMI. All impedance measurements were performed with the commercially available device BoMed NCCOM3. We measured stroke volume index, cardiac index and ejection fraction by TIC. The measurements were done on the day of admittance (day O), first day and second day continuously, and on the third to fifth day during bed rest. Comparisons of TIC measurements and vital signs were made by Friedman analysis. Group A and group B were compared by Mann Whitney U test and chi square. The level of statistical significance was set at P < 0.05. Results: There were 26 patients in group A (mean age: 62 ± 10) and 14 patients in group B (mean age: 61 ± 12). There were no statistically significant differences between the groups in age and sex. There were statistically significant differences between group A and B with regard to stroke volume index (32 ± 5 vs 28 ± 5; P = 0.0147), total peripheral resistance (19 ± 5 vs 23 ± 5; P = 0.0084); ejection fraction (0.44 ± 0.16 vs 0.58 ± 0.08; P = 0.0131). The vital signs with statistically significant differences were systolic arterial blood pressure (110 ± 17 vs 88 ± 7, P < 0.0001); diastolic arterial blood pressure (72 ± 12 vs 55 ± 13; P = 0.0002) and heart rate (89 ± 12 vs 71 ± 11; P < 0.0001). The differences disappeared on the second day. The lack of significance continued on the fifth day. Friedman analysis revealed that all the TIC parameters except for left ventricular ejection fraction change towards the normal range. Ejection fraction did not change in group B but decreased in group A on the second day; however it was stable later. Conclusion: TIC can provide easily obtained parameters which may have a role in the treatment of hemodynamically significant RVMI. This is particularly important in coronary care centers with limited invasive capabilities. A.N.E. 2000;5(4):330–335
Keywords:impedance cardiography  infarction  right ventricular infarction
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