Changes in right ventricular free wall strain in patients with coronary artery disease involving the right coronary artery

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Abstract

Background Chronic ischemia related occult systolic dysfunction of the right ventricle is difficult to detect using traditional echocardiography. The aim of this study was to verify the diagnostic value of speckle-tracking echocardiography in proximal right coronary artery (pRCA) lesion-induced right ventricular (RV) occult dysfunction. Methods One hundred forty-two patients undergoing elective coronary angiography for suspected coronary artery disease were divided into two groups according to involvement of the right coronary artery. In further analysis, significant stenosis before the acute marginal branch was defined as pRCA involvement and compared with a control group. Global longitudinal strain and RV free wall longitudinal train (RVLS-FW) were measured using speckle-tracking echocardiography. Other traditional parameters to evaluate RV function were also measured. Results Eighty-seven patients in the right coronary artery group (61.2%) displayed significant decreases in the magnitudes of both global longitudinal strain (-13.65 ± 3.83% vs -15.69 ± 4.37%, P =.04) and RVLS-FW (-16.04 ± 5.4% vs -21.18 ± 4.6%, P =.04), independent of other parameters. Conversely, when focusing on pRCA involvement, only RVLS-FW showed significant attenuation in the group with pRCA involvement (-14.26 ± 4.32% vs -19.96 ± 4.8%, P =.001). On multivariate analysis, RVLS-FW was still independently lower in the group with pRCA involvement (odds ratio, 1.07; 95% confidence interval, 1.01-1.14; P =.02). Conclusions The results of this study show that RVLS-FW was independently impaired in patients with coronary artery disease with right coronary artery stenosis, especially with involvement of the acute marginal branches. RV strain can be used to detect occult RV dysfunction in patients with stable coronary artery disease.

Original languageEnglish
Pages (from-to)230-238
Number of pages9
JournalJournal of the American Society of Echocardiography
Volume27
Issue number3
DOIs
Publication statusPublished - 2014 Mar 1

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Coronary Artery Disease
Coronary Vessels
Right Ventricular Dysfunction
Echocardiography
Right Ventricular Function
Coronary Stenosis
Patient Rights
Coronary Angiography
Heart Ventricles
Pathologic Constriction
Multivariate Analysis
Ischemia
Odds Ratio
Confidence Intervals
Control Groups

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{35e0f7456ec643db9de9b0cb09ca3304,
title = "Changes in right ventricular free wall strain in patients with coronary artery disease involving the right coronary artery",
abstract = "Background Chronic ischemia related occult systolic dysfunction of the right ventricle is difficult to detect using traditional echocardiography. The aim of this study was to verify the diagnostic value of speckle-tracking echocardiography in proximal right coronary artery (pRCA) lesion-induced right ventricular (RV) occult dysfunction. Methods One hundred forty-two patients undergoing elective coronary angiography for suspected coronary artery disease were divided into two groups according to involvement of the right coronary artery. In further analysis, significant stenosis before the acute marginal branch was defined as pRCA involvement and compared with a control group. Global longitudinal strain and RV free wall longitudinal train (RVLS-FW) were measured using speckle-tracking echocardiography. Other traditional parameters to evaluate RV function were also measured. Results Eighty-seven patients in the right coronary artery group (61.2{\%}) displayed significant decreases in the magnitudes of both global longitudinal strain (-13.65 ± 3.83{\%} vs -15.69 ± 4.37{\%}, P =.04) and RVLS-FW (-16.04 ± 5.4{\%} vs -21.18 ± 4.6{\%}, P =.04), independent of other parameters. Conversely, when focusing on pRCA involvement, only RVLS-FW showed significant attenuation in the group with pRCA involvement (-14.26 ± 4.32{\%} vs -19.96 ± 4.8{\%}, P =.001). On multivariate analysis, RVLS-FW was still independently lower in the group with pRCA involvement (odds ratio, 1.07; 95{\%} confidence interval, 1.01-1.14; P =.02). Conclusions The results of this study show that RVLS-FW was independently impaired in patients with coronary artery disease with right coronary artery stenosis, especially with involvement of the acute marginal branches. RV strain can be used to detect occult RV dysfunction in patients with stable coronary artery disease.",
author = "Chang, {Wei Ting} and Tsai, {Wei Chuan} and Liu, {Yen Wen} and Lee, {Cheng Han} and Liu, {Ping Yen} and Chen, {Ju Yi} and Li, {Yi Heng} and Tsai, {Liang Miin}",
year = "2014",
month = "3",
day = "1",
doi = "10.1016/j.echo.2013.11.010",
language = "English",
volume = "27",
pages = "230--238",
journal = "Journal of the American Society of Echocardiography",
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TY - JOUR

T1 - Changes in right ventricular free wall strain in patients with coronary artery disease involving the right coronary artery

AU - Chang, Wei Ting

AU - Tsai, Wei Chuan

AU - Liu, Yen Wen

AU - Lee, Cheng Han

AU - Liu, Ping Yen

AU - Chen, Ju Yi

AU - Li, Yi Heng

AU - Tsai, Liang Miin

PY - 2014/3/1

Y1 - 2014/3/1

N2 - Background Chronic ischemia related occult systolic dysfunction of the right ventricle is difficult to detect using traditional echocardiography. The aim of this study was to verify the diagnostic value of speckle-tracking echocardiography in proximal right coronary artery (pRCA) lesion-induced right ventricular (RV) occult dysfunction. Methods One hundred forty-two patients undergoing elective coronary angiography for suspected coronary artery disease were divided into two groups according to involvement of the right coronary artery. In further analysis, significant stenosis before the acute marginal branch was defined as pRCA involvement and compared with a control group. Global longitudinal strain and RV free wall longitudinal train (RVLS-FW) were measured using speckle-tracking echocardiography. Other traditional parameters to evaluate RV function were also measured. Results Eighty-seven patients in the right coronary artery group (61.2%) displayed significant decreases in the magnitudes of both global longitudinal strain (-13.65 ± 3.83% vs -15.69 ± 4.37%, P =.04) and RVLS-FW (-16.04 ± 5.4% vs -21.18 ± 4.6%, P =.04), independent of other parameters. Conversely, when focusing on pRCA involvement, only RVLS-FW showed significant attenuation in the group with pRCA involvement (-14.26 ± 4.32% vs -19.96 ± 4.8%, P =.001). On multivariate analysis, RVLS-FW was still independently lower in the group with pRCA involvement (odds ratio, 1.07; 95% confidence interval, 1.01-1.14; P =.02). Conclusions The results of this study show that RVLS-FW was independently impaired in patients with coronary artery disease with right coronary artery stenosis, especially with involvement of the acute marginal branches. RV strain can be used to detect occult RV dysfunction in patients with stable coronary artery disease.

AB - Background Chronic ischemia related occult systolic dysfunction of the right ventricle is difficult to detect using traditional echocardiography. The aim of this study was to verify the diagnostic value of speckle-tracking echocardiography in proximal right coronary artery (pRCA) lesion-induced right ventricular (RV) occult dysfunction. Methods One hundred forty-two patients undergoing elective coronary angiography for suspected coronary artery disease were divided into two groups according to involvement of the right coronary artery. In further analysis, significant stenosis before the acute marginal branch was defined as pRCA involvement and compared with a control group. Global longitudinal strain and RV free wall longitudinal train (RVLS-FW) were measured using speckle-tracking echocardiography. Other traditional parameters to evaluate RV function were also measured. Results Eighty-seven patients in the right coronary artery group (61.2%) displayed significant decreases in the magnitudes of both global longitudinal strain (-13.65 ± 3.83% vs -15.69 ± 4.37%, P =.04) and RVLS-FW (-16.04 ± 5.4% vs -21.18 ± 4.6%, P =.04), independent of other parameters. Conversely, when focusing on pRCA involvement, only RVLS-FW showed significant attenuation in the group with pRCA involvement (-14.26 ± 4.32% vs -19.96 ± 4.8%, P =.001). On multivariate analysis, RVLS-FW was still independently lower in the group with pRCA involvement (odds ratio, 1.07; 95% confidence interval, 1.01-1.14; P =.02). Conclusions The results of this study show that RVLS-FW was independently impaired in patients with coronary artery disease with right coronary artery stenosis, especially with involvement of the acute marginal branches. RV strain can be used to detect occult RV dysfunction in patients with stable coronary artery disease.

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U2 - 10.1016/j.echo.2013.11.010

DO - 10.1016/j.echo.2013.11.010

M3 - Article

C2 - 24332357

AN - SCOPUS:84896738188

VL - 27

SP - 230

EP - 238

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 3

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