Right coronary artery motion analysis: a novel method to measure right ventricular systolic function by selective coronary angiography

Int J Cardiovasc Imaging. 2019 Sep;35(9):1557-1561. doi: 10.1007/s10554-019-01606-9. Epub 2019 May 2.

Abstract

Right ventricular systolic dysfunction is prognostic in various cardiovascular diseases. Right ventricular systolic function is not commonly assessed in the catheterization laboratory. Therefore, we developed a novel, reproducible method to measure right ventricular systolic function during selective coronary angiography. We analyzed the angiographic systolic translational motion and maximum speed of the right coronary artery (RCA) in 97 consecutive patients and compared it to the tricuspid annular plane systolic excursion (TAPSE) as measured by echocardiography. All measurements were performed by two independent operators on two occasions. Inter-observer variability and intra-observer variability were excellent for RCA motion distance and for RCA maximum speed. There was a significant correlation of the RCA motion distance and RCA maximum speed with the TAPSE measured by echocardiography (Pearson's correlation for RCA distance: r = 0.59, p < 0.001, r2 = 0.35; for RCA speed: r = 0.40, p < 0.001, r2 = 0.16). The area under the receiver operating curve for the RCA motion distance was 0.88 (95% CI 0.80-0.96) for discrimination of normal and abnormal right ventricular systolic function. A cut-off value less than 22.3 mm systolic RCA motion had a specificity of 93.3% and a sensitivity of 75.6% for identifying an abnormal right ventricular systolic function. Analysis of the RCA motion is a reproducible and reliable method to measure right ventricular systolic function during selective coronary angiography. It is a simple and useful tool to assess right ventricular function in the catheterization laboratory and may serve for risk assessment for right ventricular failure. CLINICAL TRIAL REGISTRATION: Data for this study was collected retrospectively from Swiss Transcatheter Aortic Valve Implantation Registry (NCT01368250). https://clinicaltrials.gov/show/NCT01368250 .

Keywords: Motion analysis; Right ventricular systolic function; Selective coronary angiography; Transthoracic echocardiography; Tricuspid annular plane systolic excursion.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Angiography / methods*
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / physiopathology
  • Female
  • Humans
  • Male
  • Observer Variation
  • Organ Motion*
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Registries
  • Reproducibility of Results
  • Retrospective Studies
  • Systole
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / physiopathology
  • Ventricular Dysfunction, Right / diagnostic imaging*
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Right*

Associated data

  • ClinicalTrials.gov/NCT01368250