Right ventricular infarction with a culprit lesion in the distal right coronary artery: incidence and clinical characteristics.

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: =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.