Echocardiographic evaluation of right ventricular functions after successful percutaneous recanalization of right coronary artery chronic total occlusions

B. Ozkan, M. Urumdas, G. Alici, G. Acar, E. Alizade, M.E. Kalkan, M.M. Tabakci, S. Demir, M. Sahin, M. Bulut, A.M. Esen

Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Heart-Education and Research Hospital, Istanbul, Turkey. gokselacar81@hotmail.com

 

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• Cardiology

BACKGROUND: No data exist on regarding possible improvement will occur in right ventricular (RV) functions after successful recanalization of right coronary artery chronic total occlusions (RCA CTOs).

AIM: Our aim was to evaluate the revascularization induced changes in RV functions by novel echocardiographic techniques like tissue Doppler imaging (TDI) and two dimensional speckle tracking echocardiography (2DSTE).

PATIENTS AND METHODS: Forty-one consecutive successfully recanalized patients with RCA CTOs were included in our study. All included patients underwent standard echocardiography with TDI and 2DSTE to assess RV function before procedure and repeated after 24 hours and 1 month.

RESULTS: There were no significant changes in tricuspid annular plane systolic excursion, systolic myocardial velocities, and fractional area change values. However, RV global longitudinal strain and systolic strain rate values showed a significant increase at 24 hours after percutaneous coronary intervention compared to baseline (–23.6±4.1% vs. –19.7±3.9%, p < 0.001 and –1.55±0.18s-1 vs. –1.18±0.17s-1, p < 0.001, respectively). Moreover, improvement of the RV functions in patients with RCA CTOs was further suggested by the higher RV isovolumic acceleration values at 1-month compared with baseline (2.29±0.62 vs. 2.05±0.5 m/s2, p = 0.014).

CONCLUSIONS: TDI derived isovolumic acceleration and 2DSTE derived global longitudinal strain and systolic strain rate values showed improvement in RV functions after successful percutaneous recanalization of RCACTOs suggesting viability of RV in chronic ischemia.

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