Title: Right Atrial Geometric Changes in Patients with Proximal Versus Distal Significant Right Coronary Artery Stenosis: a Tissue Doppler imaging study
Authors: Lamiaa Khedr MD, Ehab Alguindy MD, Mohamed Abdelaal* MD, Hatem Elsokkary MD
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.58
Abstract
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 21.43±9.55, 59.65±25.55 and 62.45±28.73 in group one, two and three respectively. RA septal longitudinal systolic strain was found to be 12.96±4.13, 26.66±11.5 and 25.97±12.45 in group one, two and three respectively with p value 0.001. RA lateral wall longitudinal systolic strain rate was found to be 1.6±0.57, 2.8-12.9 and 5.8±2.37 in group one, two and three respectively with p value 0.001. RA septal wall longitudinal systolic strain rate was found to be 1.52±0.52, 2.54±1.03 and 2.44±1.01 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.
Keywords: (right atrium, systolic function, tissue Doppler imaging, ischemic heart disease, right coronary artery).
