Does coronary artery size really matter?
OBJECTIVE
To evaluate ischemia in right ventricle (RV) in patients with small caliber of right coronary artery (RCA).


METHODS
The study population consisted of 60 consecutive patients undergoing coronary angiography within 3 months. The patients were divided into three different groups according to lumen diameter of RCA and coronary dominance. Group 1, 2, and 3 consisted of patients with small diameter of RCA, dominant RCA, and dominant circumflex artery, respectively. RV ischemia was assessed by using pulse-wave tissue Doppler sampling obtained from RV free wall close to the lateral tricuspid annulus at the apical four-chamber view during dobutamine stress echocardiography (DSE).


RESULTS
When the mean systolic velocity percentages of increase from low to peak dose dobutamine in patients with small RCA were compared to those of other groups, statistically significant difference was found between group 1 and the other groups (P = 0.007 for group 1 vs group 2; P = 0.01 for group 1 vs group 3). The mean systolic velocity at peak dobutamine dose of patients with small caliber of right coronary artery was statistically lower than the other groups (P = 0.001 for group 1 vs group 2, P < 0.001 group 1 vs group 3).


CONCLUSIONS
There are a group of patients with small diameter of RCA causing probable ischemia in RV and small caliber of RCA can really matter in these patients.
Celik
Turgay
T
Department of Cardiology, Gulhane Military Medical Academy, School of Medicine, Etlik, Ankara, Turkey. benturgay@yahoo.com
Iyisoy
Atila
A
Kursaklioglu
Hurkan
H
Kose
Sedat
S
Kilic
Selim
S
Amasyali
Basri
B
Isik
Ersoy
E
D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018619:Echocardiography, Doppler, Pulsed; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018709:Statistics, Nonparametric