Key result
Proximal significant right coronary artery stenosis was associated with significantly reduced right atrial free wall systolic strain (21.43%) compared to distal stenosis (59.65%) and normal controls (62.45%, p=0.001).
Why the study?
Does proximal significant RCA stenosis impair right atrial systolic function compared to distal RCA stenosis or normal controls?
Cross-Sectional (n=45)
No
Does proximal significant RCA stenosis impair right atrial systolic function compared to distal RCA stenosis or normal controls?
Proximal significant RCA stenosis is associated with significantly impaired right atrial systolic function as measured by tissue Doppler imaging, whereas distal stenosis is not.
Proximal RCA stenosis was associated with reduced right atrial strain; hypothesis-generating and requires prospective validation before clinical use.
Background: Right atrial (RA) function is rarely investigated. Atrial contribution to the cardiac function is very important, atrial function was affected in many disease states including ischemic heart disease Subjects and Methods: This study investigated the RA function in patients with significant right coronary artery (RCA) stenosis. Patients were divided into 3 groups: group one included 15 patients with significant proximal RCA stenosis, group two included 15 patients with significant distal RCA stenosis and group three included 15 normal subjects as a control group. We measured the RA maximum and minimum volume and RA distensibility. We measured RA function using atrial longitudinal systolic strain and strain rate using 2D color-coded Tissue Doppler imaging (TDI) applied to right atrium using standard apical 4ch view. Results: We found no significant difference between the three groups regarding the RA maximal, minimal volume and distensibility. We found the RA longitudinal systolic strain and strain rate to be significantly reduced in patients with group one than patients in group two and three as the RA free wall systolic strain in group one was found to be 21. 439.55, 59.6525.55 and 62.4528.73 in group one, two and three respectively. RA septal longitudinal systolic strain was found to be 12. 964.13, 26.6611.5 and 25.9712.45 in group one, two and three respectively with p value 0.001. RA lateral wall longitudinal systolic strain rate was found to be 1. 60.57, 2.8-12.9 and 5.82.37 in group one, two and three respectively with p value 0.001. RA septal wall longitudinal systolic strain rate was found to be 1.520.52, 2.541.03 and 2.441.01 in group one, two and three respectively with p value 0.004. Conclusion: RA systolic function was found to be reduced in patients with proximal significant RCA stenosis. This finding may have therapeutic implication for the management of such patients.
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Lamiaa Khedr (2017) conducted a cross-sectional in Significant right coronary artery stenosis (n=45). Proximal significant right coronary artery stenosis vs. Distal significant right coronary artery stenosis and normal subjects was evaluated on Right atrial free wall longitudinal systolic strain (%) (p=0.001). Proximal significant right coronary artery stenosis was associated with significantly reduced right atrial free wall systolic strain (21.43%) compared to distal stenosis (59.65%) and normal controls (62.45%, p=0.001).
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