Assessment of acute right ventricular dysfunction induced by right coronary artery occlusion using echocardiographic atrioventricular plane displacement

Alpesh R. Shah, Richard Grodman, Manuel F. Salazar, Najeeb U. Rehman, John Coppola, Robert Braff

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Right ventricular (RV) systolic function analysis by echocardiography has traditionally required RV endocardial border definition with subsequent tracing and is often inaccurate or impossible in technically poor studies. The atrioventricular plane displacement (AVPD) method attempts to use the descent of the tricuspid annular ring, a reflection of the longitudinal shortening of the right ventricle, as a surrogate marker for RV systolic function. We hypothesized that RV ischemia induced during right coronary artery occlusion proximal to the major right ventricular branches would result in severe right ventricular systolic dysfunction detectable by the AVPD method. During this pilot study, seven patients undergoing elective proximal RCA angioplasty had echocardiographic measurement of RV AVPD performed at baseline (i.e., immediately prior to RCA balloon inflation), during the last 30 seconds of first RCA balloon inflation, and at 1 minute after balloon deflation (recovery). Lateral and medial RV AVPD were significantly reduced from baseline values during intracoronary balloon inflation. (Lateral: 2.45 cm ± 0.22 vs 1.77 cm ± 0.13, P < 0.001; medial: 1.46 cm ± 0.37 vs 1.28 cm ± 0.32, P < 0.05). Additionally, lateral and medial RV AVPD significantly returned towards baseline values during recovery. (Lateral: 2.39 cm ± 0.20, P < 0.001; medial: 1.58 cm ± 0.27, P = 0.01). At baseline, all lateral RV AVPD values were > 2.0 cm, whereas during balloon inflation all were < 2.0 cm. No such clear distinction was found in medial RV AVPD values. Proximal RCA angioplasty is associated with a significant reduction in lateral and medial RV AVPD. Thus RV AVPD may serve, as a marker for RV systolic dysfunction.

Original languageEnglish (US)
Pages (from-to)513-519
Number of pages7
JournalEchocardiography
Volume17
Issue number6 I
DOIs
StatePublished - 2000

Keywords

  • Atrioventricular plane displacement
  • Echocardiography
  • Right ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Assessment of acute right ventricular dysfunction induced by right coronary artery occlusion using echocardiographic atrioventricular plane displacement'. Together they form a unique fingerprint.

Cite this