Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Original Article

Volume 16, Number 3, June 2025, pages 212-224

Changes in the Right Ventricular Diameters and Systolic Function After Successful Percutaneous Coronary Intervention in Patients With First Acute Myocardial Infarction

↓ Figure 1. Measurement of the RV conventional parameters and the RV longitudinal strain in the RV-focused apical four-chamber view. (a) RV size. (b) RVS’ wave was measured using tissue Doppler imaging. (c) TAPSE measure in M-mode. (d) The end-systolic RV area and (e) end-diastolic RV area were measured for RV-FAC. (f) Automatic RVFWLS and RV4CSL measured by the QLAB AutoStrain Software. RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; RVD3: right ventricular longitudinal linear dimension; RV-FAC: right ventricular fractional area change; TAPSE: tricuspid annular plane systolic excursion; RVS’: Doppler tissue imaging-derived tricuspid lateral annular systolic velocity; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain; RV: RV: right ventricle; LV: left ventricle; EDA: end-diastolic area; ESA: end-systolic area.

↓ Figure 2. The study protocol. AMI: acute myocardial infarction; FAC: fractional area change; NSTEMI: non-ST-segment elevation myocardial infarction; PCI: percutaneous coronary intervention; RV: right ventricular; RV4CSL: right ventricular four-chamber longitudinal strain; RVD1: right ventricular basal diameter; RVD2: right ventricular mid diameter; RVD3: right ventricular longitudinal linear dimension; RVFWSL: right ventricular free wall longitudinal strain; RVS’: Doppler tissue imaging-derived tricuspid lateral annular systolic velocity; STEMI: ST-segment elevation myocardial infarction; TAPSE: tricuspid annular plane systolic excursion.

↓ **Table 1.** Baseline Demographic and Clinical Characteristics of the Overall Population
	Study group (n = 133)
^aSignificantly less than the normal range according to ASE 2015 (P < 0.05). SD: standard deviation; BMI: body mass index; IQR: interquartile range; ProBNP: pro-B-type natriuretic peptide; STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-segment elevation myocardial infarction; LVDd: left ventricular diameter in diastole; LVDs: left ventricular diameter in systole; LVEF biplane: left ventricular ejection fraction biplane; LVGLS: left ventricular global longitudinal strain; LAVI: left atrial volume index; LAD: left anterior descending artery; LCx: left circumflex artery; LM: left main artery; RCA: right coronary artery; MACEs: major adverse cardiac events; AMI: acute myocardial infarction; ASE: American Society of Echocardiography; ACEs: angiotensin-converting enzymes inhibitors.
Clinical characteristics
Mean age (years), mean ± SD (Min - Max)	68.03 ± 11.81 (36 - 93)
Male (n, %)	93 (69.92%)
BMI (kg/m²)	22.26 ± 2.77
Hypertension (n, %)	81 (60.9%)
Diabetes mellitus (n, %)	38 (28.57%)
Chronic renal disease (n, %)	7 (5.3%)
Time of admission (h), median (IQR)	5 (2.75 - 14)
Door to balloon time (h), median (IQR)	4 (2 - 7.5)
Heart rate (bpm), median (IQR)	80 (70 - 89)
Hospital duration (days)	8.89 ± 4.29
Systolic blood pressure (mm Hg), mean ± SD	131.61 ± 21.38
Troponin I (pg/mL), median (IQR)	1,253.40 (189.05 - 4,152.20)
ProBNP (pg/mL), median (IQR)	625.10 (97.87 - 5,659.70)
STEMI (n, %)	107 (80.50)
NSTEMI (n, %)	26 (19.50)
Killips classification (n, %)
Killips I	75 (56.39)
Killips II	46 (34.58)
Killips III, IV	12 (9.03)
Left ventricular echocardiographic parameters
LVDd (mm) (mean ± SD)	45.32 ± 6.20
LVDs (mm), median (IQR)	30.00 (26.92 - 34.15)
LVEF biplane (%) (mean ± SD)	47.31 ± 9.41^a
LVGLS (%) (mean ± SD)	-10.26 ± 3.37^a
LAVI (mL/m²), median (IQR)	21.12 (15.47 - 28.47)
Regional wall movement abnormality (n, %)	120 (90.22)
Characteristics of coronary arterial lesions
Culprit coronary artery (n, %)
LAD	65 (48.87)
LCx	18 (13.53)
RCA	47 (35.33)
LM	3 (2.27)
Severity of culprit coronary arterial stenosis (n, %)
100%	71 (53.38)
99%	21 (15.78)
Less than 99%	41 (30.84)
Numbers of coronary arterial lesions (n, %)
1	56 (42.10)
2	36 (27.06)
≥ 3	41 (30.84)
Drugs (n, %)
Aspirin	133 (100)
Clopidogrel	87 (65.41)
Ticagrelor	46 (34.58)
Statin	133 (100)
ACEs	63 (47.36)
Beta blockers	28 (21.05)
Anticoagulation (unfractionated heparin, low-molecular-weight heparin)	133 (100)
MACEs (n, %)	7 (5.26)
Death	2 (1.50) (1 at hospital duration and 1 during follow-up)
Hospitalization due to heart failure	4 (3.00)
Recurrent AMI	1 (0.75)

↓ Table 1. Baseline Demographic and Clinical Characteristics of the Overall Population

Study group (n = 133)

^aSignificantly less than the normal range according to ASE 2015 (P < 0.05). SD: standard deviation; BMI: body mass index; IQR: interquartile range; ProBNP: pro-B-type natriuretic peptide; STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-segment elevation myocardial infarction; LVDd: left ventricular diameter in diastole; LVDs: left ventricular diameter in systole; LVEF biplane: left ventricular ejection fraction biplane; LVGLS: left ventricular global longitudinal strain; LAVI: left atrial volume index; LAD: left anterior descending artery; LCx: left circumflex artery; LM: left main artery; RCA: right coronary artery; MACEs: major adverse cardiac events; AMI: acute myocardial infarction; ASE: American Society of Echocardiography; ACEs: angiotensin-converting enzymes inhibitors.

Clinical characteristics

Mean age (years), mean ± SD (Min - Max)

68.03 ± 11.81 (36 - 93)

Male (n, %)

93 (69.92%)

BMI (kg/m²)

22.26 ± 2.77

Hypertension (n, %)

81 (60.9%)

Diabetes mellitus (n, %)

38 (28.57%)

Chronic renal disease (n, %)

7 (5.3%)

Time of admission (h), median (IQR)

5 (2.75 - 14)

Door to balloon time (h), median (IQR)

4 (2 - 7.5)

Heart rate (bpm), median (IQR)

80 (70 - 89)

Hospital duration (days)

8.89 ± 4.29

Systolic blood pressure (mm Hg), mean ± SD

131.61 ± 21.38

Troponin I (pg/mL), median (IQR)

1,253.40 (189.05 - 4,152.20)

ProBNP (pg/mL), median (IQR)

625.10 (97.87 - 5,659.70)

STEMI (n, %)

107 (80.50)

NSTEMI (n, %)

26 (19.50)

Killips classification (n, %)

Killips I

75 (56.39)

Killips II

46 (34.58)

Killips III, IV

12 (9.03)

Left ventricular echocardiographic parameters

LVDd (mm) (mean ± SD)

45.32 ± 6.20

LVDs (mm), median (IQR)

30.00 (26.92 - 34.15)

LVEF biplane (%) (mean ± SD)

47.31 ± 9.41^a

LVGLS (%) (mean ± SD)

-10.26 ± 3.37^a

LAVI (mL/m²), median (IQR)

21.12 (15.47 - 28.47)

Regional wall movement abnormality (n, %)

120 (90.22)

Characteristics of coronary arterial lesions

Culprit coronary artery (n, %)

LAD

65 (48.87)

LCx

18 (13.53)

RCA

47 (35.33)

3 (2.27)

Severity of culprit coronary arterial stenosis (n, %)

100%

71 (53.38)

99%

21 (15.78)

Less than 99%

41 (30.84)

Numbers of coronary arterial lesions (n, %)

56 (42.10)

36 (27.06)

≥ 3

41 (30.84)

Drugs (n, %)

Aspirin

133 (100)

Clopidogrel

87 (65.41)

Ticagrelor

46 (34.58)

Statin

133 (100)

ACEs

63 (47.36)

Beta blockers

28 (21.05)

Anticoagulation (unfractionated heparin, low-molecular-weight heparin)

133 (100)

MACEs (n, %)

7 (5.26)

Death

2 (1.50) (1 at hospital duration and 1 during follow-up)

Hospitalization due to heart failure

4 (3.00)

Recurrent AMI

1 (0.75)

↓ **Table 2.** Baseline Echocardiographic Characteristics of Right Ventricular Diameters and Systolic Function in the Study Group
Echo data	Study group (n = 133)	Normal range (mean)	P^a	Numbers of abnormal (n, %)
^aP one-tail when comparing the mean/median value of study variables with the threshold value of reference range according to ASE guidelines 2015. ^bSignificant differences from the reference interval threshold value. RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; RVD3: right ventricular longitudinal linear dimension; RVWT: right ventricular wall thickness; TAPSE: tricuspid annular plane systolic excursion; FAC: fractional area change; RVS’: Doppler tissue imaging-derived tricuspid lateral annular systolic velocity; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain; ASE: American Society of Echocardiography.
RVD1 (mm)	27.96 ± 5.58	25 - 41 (33)	1	3 (2.25)
RVD2 (mm)	21.58 ± 4.70	19 - 35 (27)	1	16 (12.03)
RVD3 (mm)	57.76 ± 11,59	59 - 83 (71)	1	0 (0)
RVWT (mm)	5.6 (5.3 - 6.7)^b	1 - 5 (3)^b	0.01^b	70 (52.63%)^b
TAPSE (mm)	20 (18.4 - 23)	≥ 17	1	15 (11.27)
FAC (%)	45.29 ± 10.19	≥ 35	0.68	20 (15.03)
RVS’ (cm/s)	12.4 (10.6 - 13.8)	≥ 9.5	0.91	7 (5.26)
RVFWSL (%)	-18.28 ± 8.77^b	≤ -20^b	< 0.001^b	83 (62.40)^b
RV4CSL (%)	-14.78 ± 6.94^b	≤ -20^b	< 0.001^b	111 (83.45)^b

↓ Table 2. Baseline Echocardiographic Characteristics of Right Ventricular Diameters and Systolic Function in the Study Group

Echo data

Study group (n = 133)

Normal range (mean)

P^a

Numbers of abnormal (n, %)

^aP one-tail when comparing the mean/median value of study variables with the threshold value of reference range according to ASE guidelines 2015. ^bSignificant differences from the reference interval threshold value. RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; RVD3: right ventricular longitudinal linear dimension; RVWT: right ventricular wall thickness; TAPSE: tricuspid annular plane systolic excursion; FAC: fractional area change; RVS’: Doppler tissue imaging-derived tricuspid lateral annular systolic velocity; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain; ASE: American Society of Echocardiography.

RVD1 (mm)

27.96 ± 5.58

25 - 41 (33)

3 (2.25)

RVD2 (mm)

21.58 ± 4.70

19 - 35 (27)

16 (12.03)

RVD3 (mm)

57.76 ± 11,59

59 - 83 (71)

0 (0)

RVWT (mm)

5.6 (5.3 - 6.7)^b

1 - 5 (3)^b

0.01^b

70 (52.63%)^b

TAPSE (mm)

20 (18.4 - 23)

≥ 17

15 (11.27)

FAC (%)

45.29 ± 10.19

≥ 35

0.68

20 (15.03)

RVS’ (cm/s)

12.4 (10.6 - 13.8)

≥ 9.5

0.91

7 (5.26)

RVFWSL (%)

-18.28 ± 8.77^b

≤ -20^b

< 0.001^b

83 (62.40)^b

RV4CSL (%)

-14.78 ± 6.94^b

≤ -20^b

< 0.001^b

111 (83.45)^b

↓ **Table 3.** Echocardiographic Evaluation of Right Ventricular Diameters and Systolic Functions in Clinical Subgroups of Study Group at Baseline
Subgroups (n = 133)	RVD1 (mm)	RVD2 (mm)	TAPSE (mm)	FAC (%)	RVFWSL (%)	RV4CSL (%)
^aSignificant differences. STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-segment elevation myocardial infarction; LAD: left anterior descending artery; LCx: left circumflex artery; LM: left main artery; RCA: right coronary artery; MACE: major adverse cardiac event; RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; TAPSE: tricuspid annular plane systolic excursion; FAC: fractional area change; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain.
Types of myocardial infarction (n = 133)
STEMI (n = 107)	28.2 ± 5.4	21.6 ± 4.5	20.2 (10.6 - 13.9)	45.2 ± 10.1	-17.5 ± 8.4^a	-14.3 ± 6.7^a
NSTEMI (n = 26)	27.2 ± 4.8	20.6 ± 4.5	20.0 (19.1 - 24.8)	46.2 ± 10.5	-22.2 ± 9.7^a	-17.1 ± 8.9^a
P	0.78	0.23	0.19	0.66	0.04^a	0.04^a
Culprit coronary artery lesion (n = 133)
LAD (n = 65)	27.4 ± 5.1^a	20.1 ± 4.1^a	20.2 (18.0 - 23.6)	46.7 ± 9.6^a	-17.5 ± 9.7	-12.9 ± 7.3
LCx (n = 18)	26.6 ± 5.2^a	22.4 ± 5.6^a	19.1 (18.0 - 21.1)	42.4 ± 8.0^a	-22.3 ± 7.0	-17.3 ± 5.9
RCA (n = 47)	29.8 ± 5.4^a	22.7 ± 4.2^a	20.0 (18.4 - 21.0)	42.1 ± 11.8^a	-18.3 ± 7.1	-15.6 ± 6.0
LM (n = 3)	31.5 ± 6.2^a	24.2 ± 4.8^a	22.4 (18.5 - 28.1)	49.9 ± 11.1^a	-15.4 ± 2.8	-11.7 ± 3.0
P	0.02^a	0.02^a	0.42	0.03^a	0.56	0.63
Killip classification (n = 133)
Killip I (n = 75)	28.9 ± 6.0	21.0 ± 4.2	20.4 (18.1 - 22.9)^a	45.4 ± 9.9^a	-18.4 (-24.4; -13.0)^a	-14.5 (-17.7; -10.4)^a
Killip II (n = 46)	27.06 ± 6.2	21.1 ± 5.2	20.0 (18.5 - 23.8)^a	47.1 ± 9.7^a	-18.3 (-23.2; -11.8)^a	-14.4 (-19.0; -8.9)^a
Killip III, IV (n = 12)	29.9 ± 5.8	23.1 ± 5.4	17.3 (11.5 - 19.9)^a	36.7 ± 12.0^a	-5.0 (-8.5; -2.5)^a	-8.8 (-14.0; -4.1)^a
P	0.66	0.06	0.03^a	< 0.001^a	0.03^a	0.04^a
MACE (n = 133)
MACE (+) (n = 7)	31.2 ± 3.8	24.1 ± 4.8	21.0 (18.4 - 22.8)	46.1 ± 15.3	-17.3 ± 10.9	-13.1 ± 9.9
MACE (-) (n = 126)	28.1 ± 8.1	21.1 ± 4.7	20.0 (17.7 - 23.0)	45.1 ± 10.0	-17.7 ± 8.1	-14.2 ± 6.5
P	0.11	0.06	0.75	0.81	0.91	0.81

↓ Table 3. Echocardiographic Evaluation of Right Ventricular Diameters and Systolic Functions in Clinical Subgroups of Study Group at Baseline

Subgroups (n = 133)

RVD1 (mm)

RVD2 (mm)

TAPSE (mm)

FAC (%)

RVFWSL (%)

RV4CSL (%)

^aSignificant differences. STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST-segment elevation myocardial infarction; LAD: left anterior descending artery; LCx: left circumflex artery; LM: left main artery; RCA: right coronary artery; MACE: major adverse cardiac event; RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; TAPSE: tricuspid annular plane systolic excursion; FAC: fractional area change; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain.

Types of myocardial infarction (n = 133)

STEMI (n = 107)

28.2 ± 5.4

21.6 ± 4.5

20.2 (10.6 - 13.9)

45.2 ± 10.1

-17.5 ± 8.4^a

-14.3 ± 6.7^a

NSTEMI (n = 26)

27.2 ± 4.8

20.6 ± 4.5

20.0 (19.1 - 24.8)

46.2 ± 10.5

-22.2 ± 9.7^a

-17.1 ± 8.9^a

0.78

0.23

0.19

0.66

0.04^a

Culprit coronary artery lesion (n = 133)

LAD (n = 65)

27.4 ± 5.1^a

20.1 ± 4.1^a

20.2 (18.0 - 23.6)

46.7 ± 9.6^a

-17.5 ± 9.7

-12.9 ± 7.3

LCx (n = 18)

26.6 ± 5.2^a

22.4 ± 5.6^a

19.1 (18.0 - 21.1)

42.4 ± 8.0^a

-22.3 ± 7.0

-17.3 ± 5.9

RCA (n = 47)

29.8 ± 5.4^a

22.7 ± 4.2^a

20.0 (18.4 - 21.0)

42.1 ± 11.8^a

-18.3 ± 7.1

-15.6 ± 6.0

LM (n = 3)

31.5 ± 6.2^a

24.2 ± 4.8^a

22.4 (18.5 - 28.1)

49.9 ± 11.1^a

-15.4 ± 2.8

-11.7 ± 3.0

0.02^a

0.42

0.03^a

0.56

0.63

Killip classification (n = 133)

Killip I (n = 75)

28.9 ± 6.0

21.0 ± 4.2

20.4 (18.1 - 22.9)^a

45.4 ± 9.9^a

-18.4 (-24.4; -13.0)^a

-14.5 (-17.7; -10.4)^a

Killip II (n = 46)

27.06 ± 6.2

21.1 ± 5.2

20.0 (18.5 - 23.8)^a

47.1 ± 9.7^a

-18.3 (-23.2; -11.8)^a

-14.4 (-19.0; -8.9)^a

Killip III, IV (n = 12)

29.9 ± 5.8

23.1 ± 5.4

17.3 (11.5 - 19.9)^a

36.7 ± 12.0^a

-5.0 (-8.5; -2.5)^a

-8.8 (-14.0; -4.1)^a

0.66

0.06

0.03^a

< 0.001^a

0.03^a

0.04^a

MACE (n = 133)

MACE (+) (n = 7)

31.2 ± 3.8

24.1 ± 4.8

21.0 (18.4 - 22.8)

46.1 ± 15.3

-17.3 ± 10.9

-13.1 ± 9.9

MACE (-) (n = 126)

28.1 ± 8.1

21.1 ± 4.7

20.0 (17.7 - 23.0)

45.1 ± 10.0

-17.7 ± 8.1

-14.2 ± 6.5

0.11

0.06

0.75

0.81

0.91

0.81

↓ **Table 4.** Multivariate Linear Regression Analysis of Factors Affecting Right Ventricular Longitudinal Strain at Baseline (N = 133)
Parameters	RVFWSL (R² = 0.39) (P < 0.001)	RV4CSL (R² = 0.32) (P = 0.01)
^a1: LAD; 2: LCx; 3: RCA; 4: others. ^b1: Killip I; 2: Killip II; 3: Killip III, IV. ^c1: 100%; 2: 99%; 3: less than 99%. ^dSignificant differences. BMI: body mass index; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide; STEMI: ST-elevation myocardial infarction; EF: ejection fraction; LVGLS: left ventricular global longitudinal strain; MACE: major adverse cardiac event; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain; LAD: left anterior descending artery; LCx: left circumflex artery; RCA: right coronary artery.
Age (years)	0.18	0.05	0.10	0.29
Male	-0.14	0.12	-0.13	0.18
STEMI	0.13	0.14	0.07	0.42
BMI (kg/m²)	0.27^d	< 0.001^d	0.24^d	0.01^d
Troponin I (pg/mL)	-0.28^d	< 0.001^d	-0.22^d	0.01^d
NT-pro-BNP (pg/mL)	0.02	0.79	0.00	0.94
EF biplane (%)	-0.23^d	0.02^d	-0.31^d	< 0.001^d
LVGLS (%)	0.24^d	0.01^d	0.18	0.08
MACE (+)	-0.19^d	0.04^d	-0.14	0.16
Culprit coronary artery lesion^a	0.08	0.37	0.03	0.70
Number of coronary artery lesions	-0.02	0.81	-0.03	0.71
Killips classification^b	0.15	0.06	0.07	0.42
The severity of the culprit coronary artery lesion^c	0.05	0.62	0.04	0.64

↓ Table 4. Multivariate Linear Regression Analysis of Factors Affecting Right Ventricular Longitudinal Strain at Baseline (N = 133)

Parameters

RVFWSL (R² = 0.39) (P < 0.001)

RV4CSL (R² = 0.32) (P = 0.01)

P value

^a1: LAD; 2: LCx; 3: RCA; 4: others. ^b1: Killip I; 2: Killip II; 3: Killip III, IV. ^c1: 100%; 2: 99%; 3: less than 99%. ^dSignificant differences. BMI: body mass index; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide; STEMI: ST-elevation myocardial infarction; EF: ejection fraction; LVGLS: left ventricular global longitudinal strain; MACE: major adverse cardiac event; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain; LAD: left anterior descending artery; LCx: left circumflex artery; RCA: right coronary artery.

Age (years)

0.18

0.05

0.10

0.29

Male

-0.14

0.12

-0.13

0.18

STEMI

0.13

0.14

0.07

0.42

BMI (kg/m²)

0.27^d

< 0.001^d

0.24^d

0.01^d

Troponin I (pg/mL)

-0.28^d

< 0.001^d

-0.22^d

0.01^d

NT-pro-BNP (pg/mL)

0.02

0.79

0.00

0.94

EF biplane (%)

-0.23^d

0.02^d

-0.31^d

< 0.001^d

LVGLS (%)

0.24^d

0.01^d

0.18

0.08

MACE (+)

-0.19^d

0.04^d

-0.14

0.16

Culprit coronary artery lesion^a

0.08

0.37

0.03

0.70

Number of coronary artery lesions

-0.02

0.81

-0.03

0.71

Killips classification^b

0.15

0.06

0.07

0.42

The severity of the culprit coronary artery lesion^c

0.05

0.62

0.04

0.64

↓ **Table 5.** Comparison of Right Ventricular Diameters and Systolic Function Parameters at Baseline and 1-Month After Discharge
Echo data (n = 75)	Baseline	1-month	P
^aSignificant differences. LVEF biplane: left ventricular ejection fraction biplane; LVGLS: left ventricular global longitudinal strain; RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; RVD3: right ventricular longitudinal linear dimension; RVWT: right ventricular wall thickness; TAPSE: tricuspid annular plane systolic excursion; FAC: fractional area change; RVS’: Doppler tissue imaging-derived tricuspid lateral annular systolic velocity; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain.
LVEF biplane (%)	47.3 ± 8.5	48.0 ± 10.0	0.55
LVGLS (%)	-10.1 (-11.5; -8.2)	-10.0 (-12.6; -7.9)	0.57
RVD1 (mm)	27.0 (25.0 - 31.3)	29.6 (25.3 - 30.7)	0.97
RVD2 (mm)	20.6 (17.8 - 24.4)	19.8 (16.5 - 22.0)	0.05
RVD3 (mm)	61.9 ± 9.4^a	63.8 ± 8.9^a	< 0.001^a
TAPSE (mm)	20.7 (18.4 - 22.9)	20.0(18.8 - 23.0)	0.78
FAC (%)	44.5 ± 10.3	45.4 ± 10.4	0.80
RVS’ (cm/s)	12.4 (10.7 - 13.6)	12.0 (10.6 - 13.0)	0.10
RVFWSL (%)	-15.7 ± 7.2^a	-17.8 ± 6.9^a	0.04^a
RV4CSL (%)	-12.6 ± 5.6^a	-14.3 ± 5.2^a	< 0.001^a

↓ Table 5. Comparison of Right Ventricular Diameters and Systolic Function Parameters at Baseline and 1-Month After Discharge

Echo data (n = 75)

Baseline

1-month

^aSignificant differences. LVEF biplane: left ventricular ejection fraction biplane; LVGLS: left ventricular global longitudinal strain; RVD1: right ventricular basal diameter; RVD2: right ventricular mid-cavity diameter; RVD3: right ventricular longitudinal linear dimension; RVWT: right ventricular wall thickness; TAPSE: tricuspid annular plane systolic excursion; FAC: fractional area change; RVS’: Doppler tissue imaging-derived tricuspid lateral annular systolic velocity; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain.

LVEF biplane (%)

47.3 ± 8.5

48.0 ± 10.0

0.55

LVGLS (%)

-10.1 (-11.5; -8.2)

-10.0 (-12.6; -7.9)

0.57

RVD1 (mm)

27.0 (25.0 - 31.3)

29.6 (25.3 - 30.7)

0.97

RVD2 (mm)

20.6 (17.8 - 24.4)

19.8 (16.5 - 22.0)

0.05

RVD3 (mm)

61.9 ± 9.4^a

63.8 ± 8.9^a

< 0.001^a

TAPSE (mm)

20.7 (18.4 - 22.9)

20.0(18.8 - 23.0)

0.78

FAC (%)

44.5 ± 10.3

45.4 ± 10.4

0.80

RVS’ (cm/s)

12.4 (10.7 - 13.6)

12.0 (10.6 - 13.0)

0.10

RVFWSL (%)

-15.7 ± 7.2^a

-17.8 ± 6.9^a

0.04^a

RV4CSL (%)

-12.6 ± 5.6^a

-14.3 ± 5.2^a

< 0.001^a

↓ **Table 6.** Changes of Right Ventricular Longitudinal Strain at Baseline and 1-Month After Discharge in Clinical Subgroups
Subgroup (total n = 75)	Parameter	Baseline	1-month	P value
^aSignificant differences. MACE: major adverse cardiac event; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain.
MACE
MACE (+) (n = 6)	RVFWSL (%)	-17.1 ± 0.2	-10.3 ± 6.7	0.38
	RV4CSL (%)	-13.5 ± 0.7	-7.1 ± 6.5	0.36
MACE (-) (n = 69)	RVFWSL (%)	-15.7 ± 7.3^a	-18.0 ± 6.9^a	0.01^a
	RV4CSL (%)	-12.6 ± 5.6^a	-16.5 ± 5.5^a	0.02^a
Killips classification
Killips I (n = 42)	RVFWSL (%)	-16.4 ± 5.3	-18.0 ± 6.2	0.19
	RV4CSL (%)	-13.2 ± 5.0	-14.6 ± 5.4	0.14
Killips II (n = 27)	RVFWSL (%)	-16.4 ± 7.9	-18.0 ± 8.1	0.42
	RV4CSL (%)	-12.9 ± 6.1	-14.3 ± 5.9	0.36
Killips III, IV (n = 6)	RVFWSL (%)	-7.5 ± 5.2^a	-15.4 ± 6.5^a	0.03^a
	RV4CSL (%)	-7.0 (-11.2; -3.1)^a	-11.4 (-15.1; -9.3)^a	0.02^a
Number of coronary artery lesions
1 vessel disease (n = 31)	RVFWSL (%)	-14.6 ± 6.9^a	-18.1 ± 5.3^a	< 0.001^a
	RV4CSL (%)	-11.9 ± 5.5^a	-15.0 ± 4.2^a	< 0.001^a
2 vessel disease (n = 16)	RVFWSL (%)	-17.0 ± 7.3	-17.2 ± 7.7	0.94
	RV4CSL (%)	-13.7 ± 5.5	-12.9 ± 5.8	0.91
3 vessel disease (n = 28)	RVFWSL (%)	-16.2 ± 7.4	-17.8 ± 8.2	0.39
	RV4CSL (%)	-12.7 ± 5.8	-13.8 ± 6.8	0.37

↓ Table 6. Changes of Right Ventricular Longitudinal Strain at Baseline and 1-Month After Discharge in Clinical Subgroups

Subgroup (total n = 75)

Parameter

Baseline

1-month

P value

^aSignificant differences. MACE: major adverse cardiac event; RVFWSL: right ventricular free wall longitudinal strain; RV4CSL: right ventricular four-chamber longitudinal strain.

MACE

MACE (+) (n = 6)

RVFWSL (%)

-17.1 ± 0.2

-10.3 ± 6.7

0.38

RV4CSL (%)

-13.5 ± 0.7

-7.1 ± 6.5

0.36

MACE (-) (n = 69)

RVFWSL (%)

-15.7 ± 7.3^a

-18.0 ± 6.9^a

0.01^a

RV4CSL (%)

-12.6 ± 5.6^a

-16.5 ± 5.5^a

0.02^a

Killips classification

Killips I (n = 42)

RVFWSL (%)

-16.4 ± 5.3

-18.0 ± 6.2

0.19

RV4CSL (%)

-13.2 ± 5.0

-14.6 ± 5.4

0.14

Killips II (n = 27)

RVFWSL (%)

-16.4 ± 7.9

-18.0 ± 8.1

0.42

RV4CSL (%)

-12.9 ± 6.1

-14.3 ± 5.9

0.36

Killips III, IV (n = 6)

RVFWSL (%)

-7.5 ± 5.2^a

-15.4 ± 6.5^a

0.03^a

RV4CSL (%)

-7.0 (-11.2; -3.1)^a

-11.4 (-15.1; -9.3)^a

0.02^a

Number of coronary artery lesions

1 vessel disease (n = 31)

RVFWSL (%)

-14.6 ± 6.9^a

-18.1 ± 5.3^a

< 0.001^a

RV4CSL (%)

-11.9 ± 5.5^a

-15.0 ± 4.2^a

< 0.001^a

2 vessel disease (n = 16)

RVFWSL (%)

-17.0 ± 7.3

-17.2 ± 7.7

0.94

RV4CSL (%)

-13.7 ± 5.5

-12.9 ± 5.8

0.91

3 vessel disease (n = 28)

RVFWSL (%)

-16.2 ± 7.4

-17.8 ± 8.2

0.39

RV4CSL (%)

-12.7 ± 5.8

-13.8 ± 6.8

0.37