Echocardiographic assessment of right ventricular functions in patients with proximal right coronary artery chronic...

Area of Science:

• Cardiology
• Echocardiography
• Interventional Cardiology

Background:

• Proximal right coronary artery chronic total occlusion (RCA CTO) can affect cardiac function.
• Right ventricular (RV) function assessment is crucial in coronary artery disease.
• Echocardiography provides valuable insights into RV performance.

Purpose of the Study:

• To evaluate right ventricular (RV) functions using echocardiography in patients with proximal right coronary artery (RCA) chronic total occlusion (CTO).
• To correlate echocardiographic RV parameters with clinical and angiographic variables in these patients.
• To investigate the impact of myocardial infarction (MI) and coronary collateral status on RV function.

Main Methods:

• Sixty consecutive patients with proximal RCA CTO and no significant left coronary lesions were studied.
• Echocardiography was used to measure various left and right ventricular dimensions and functional parameters, including RV fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE).
• Coronary collateral grades were assessed, and Doppler myocardial performance index (MPI) was calculated.

Main Results:

• Doppler MPI showed significant negative correlations with TAPSE and RVFAC, and positive correlations with trans-tricuspid E/A and E/e' ratios.
• Patients with evidence of MI had significantly lower RVFAC, TAPSE, and higher MPI and E/A ratios compared to those without MI.
• Poorly developed coronary collaterals were associated with lower TAPSE and RVFAC, and higher MPI.

Conclusions:

• Proximal RCA CTO patients with inferior wall MI exhibit impaired RV function and poorly developed coronary collaterals.
• The presence of well-developed coronary collaterals in proximal RCA CTO is associated with better RV function.
• Echocardiographic parameters effectively assess RV dysfunction in the context of proximal RCA CTO.