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Updated: Jul 20, 2025

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

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Evaluation of right-ventricular function by two-dimensional echocardiography and two-dimensional speckle-tracking

Recha Blessing1, Ioannis Drosos2, Michael Molitor3,4

  • 1Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany. recha.blessing@unimedizin-mainz.de.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|August 1, 2023
PubMed

Insights

Successful recanalization of the right coronary artery chronic total occlusion (RCA CTO) significantly improves right-ventricular (RV) function and patient symptoms. This study highlights the benefits of CTO procedures for symptomatic individuals.

Area of Science:

  • Cardiology
  • Echocardiography
  • Interventional Cardiology

Background:

  • Chronic total occlusion (CTO) of the right coronary artery (RCA) is prevalent in coronary artery disease patients.
  • While revascularization success has improved, the impact on right-ventricular (RV) function remains understudied.
  • Assessing RV function post-RCA CTO recanalization is crucial for comprehensive patient care.

Purpose of the Study:

  • To evaluate the effects of successful RCA CTO recanalization on RV function.
  • To compare RV function before and after percutaneous coronary intervention (PCI) using advanced echocardiographic techniques.
  • To determine if RCA CTO recanalization offers clinical benefits beyond coronary flow restoration.

Main Methods:

  • A cohort of 102 patients with successful RCA CTO recanalization was analyzed.
  • Two-dimensional transthoracic echocardiography (2DE) and 2D speckle-tracking echocardiography (2DSTE) were employed.
  • RV function was assessed before PCI and at a 6-month follow-up.

Main Results:

  • Baseline RV function was altered in patients with RCA CTO, as indicated by 2DSTE strain parameters.
  • A significant improvement in RV free wall strain and global strain was observed at 6-month follow-up (p < 0.001).
  • Successful recanalization led to enhanced RV function compared to pre-procedure assessments.

Conclusions:

  • Right-ventricular function is significantly impaired in patients with RCA CTO.
  • Successful recanalization of RCA CTO leads to substantial improvement in RV function.
  • The study suggests that CTO procedures are beneficial for symptomatic patients, improving both RV function and clinical outcomes.
Abstract

Keywords:
Chronic total occlusion (CTO)Coronary artery diseasePercutaneous coronary intervention (PCI)Right ventricle (RV)Two-dimensional speckle-tracking echocardiography (2DESTE)

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