The Impact of Isolated Right Coronary Artery Angioplasty on Right Ventricular Functions in Patients with Unstable Angina Pectoris

Abstract

*Corresponding author: Yavuzer Koza, Ataturk University, Faculty of Medicine, Department of Cardiology, Erzurum, Turkey Tel: +90-4422318503, E-mail: yavuzerkoza@hotmail.com Percutaneous Coronary Intervention (PCI) has been an integral part of management of coronary artery disease over the past three decades. PCI reduces mortality in ST-segment Elevation Myocardial Infarction (STEMI) and improves cardiovascular outcomes in non-STEMI and unstable angina (1, 2). However, the role of PCI in management of stable coronary artery disease is still debatable (3). Although determined by interaction of a large number of factors, prognosis of patients with myocardial infarction is directly related to Left Ventricular (LV) function and size (4). In clinical practice, the right ventricle has remained a forgotten chamber behind the left ventricle. Likewise, most studies have evaluated the prognostic importance of LV function with little interest in the right ventricle. However, involvement of the right ventricle was significantly associated with increased mortality in patients with acute STEMI treated with primary PCI (5). The study by Nikdoust et al. (6) in a recent issue of the International Cardiovascular Research Journal highlights a significant improvement in Right Ventricular (RV) function, but not LV function, after Right Coronary Artery (RCA) PCI in patients with unstable angina. Echocardiographic measurements were performed in a total of 30 subjects prior to elective PCI. Two months after PCI, echocardiography was repeated and the results were compared to baseline. According to the findings, RV systolic and diastolic functional parameters were significantly improved, but there was no significant correlation between these parameters and LV function. Thus, the authors suggested that revascularization of the RCA might be beneficial for patients suffering from RV failure due to ischemia. The significant improvement in RV, but not LV, function, after right coronary PCI in a relatively small population is interesting. In agreement with this study, previous studies also reported significant improvements in RV function after PCI. However, these studies mainly included STEMI patients with different locations (5). In a study on 133 patients with inferior infarction without concomitant RV infarction who underwent primary PCI, only regional RV ►Implication for health policy/practice/research/medical education: To date, the impact of the percutaneous intervention on left ventricular function has been widely studied, with little interest in the right ventricle. This article highlights the importance of the interdependence of the right and left ventricles and the role of percutaneous coronary intervention in the right ventricular function with regard to different lesion sites after isolated right coronary angioplasty.