Multimodal non-invasive ultrasound for predicting severe coronary artery stenosis in right coronary dominant patients

To assess the predictive value of multimodal non-invasive ultrasound in detecting severe coronary artery stenosis (CAS) in patients with right coronary artery dominance. This prospective observational study enrolled patients undergoing coronary angiography and non-invasive echocardiography at the Department of Cardiology, Luzhou People’s Hospital, between December 2021 and August 2023. Severe CAS (SCAS) was defined as CAS ≥ 75% based on angiographic results. Patients were categorized into the SCAS group and the NSCAS group (non-severe CAS). A total of 121 patients were included, with 98 in the NSCAS group and 23 in the SCAS group. Compared to the NSCAS group, the SCAS group showed a lower left ventricular ejection fraction (LVEF) (49.3 ± 9.8% vs. 58.9 ± 5.2%, p = 0.028), a higher left ventricular end-systolic diameter(LVsd) (35.2 ± 7.7 mm vs. 29.8 ± 5.0 mm, p = 0.020), and a higher end-systolic volume༈ESV༉ (54.0 ± 23.0 ml vs. 35.7 ± 21.8 ml, p = 0.041). According to the receiver operating characteristic curve analysis, the optimal cutoff values for predicting SCAS are as follows: motion score, 1.5; ESV, 47.5 ml; LVsd, 30.5 mm; LVEF, 53.5%; mitral annular systolic velocity༈Smv༉, 8.5 cm/s; and global longitudinal peak strain༈GLPS༉, -16.5% (all p < 0.05). Multivariate logistic regression showed that LVEF was associated with SCAS (OR = 1.600, 95% CI:1.037–2.468, P = 0.034). Our findings suggest that LVEF may play a role in predicting SCAS, validating non-invasive ultrasound as an effective early diagnostic tool for patients with right coronary artery dominance. Not applicable.