Objectives: Coronary chronic total occlusion (CTO)  are encountered in about 15-25% of patients with coronary artery disease undergoing coronary angiography. After neutral findings, recent evidence has demonstrated several benefits after successful CTO revascularization, especially in terms of angina relief and myocardial ischemia reduction. The impact of successful CTO PCI on cardiac function is incompletely understood. Here, right ventricular function has not been investigated yet. In our study, we aimed to evaluate right heart function after successful RCA CTO PCI using transthoracic echocardiography with additional strain assessment.

Methods & Results: At the University Medical Center in Mainz 60 patients were included in the study. We evaluated demographic, clinical, angiographic, and periprocedural information. Right ventricular and atrial function was assessed by two-dimensional echocardiography and strain imaging.

Two-dimensional echocardiography and strain imaging was performed before and 6 months after successful RCA CTO PCI. The median age of the total collective was 67 (30-90) years. Right ventricular function assessed by strain imaging improved after RCA CTO PCI (RVFW  -19.84±6.32 vs -22.70± 5.58, p < 0.001 and RV4C -15.4±4.77 vs -17.28± 4.38, p < 0.001).

Mean RA reservoir strain at baseline was 25.6± 9.4 and 27.9± 11.0 in follow up (p 0.03). Mean RA conduit strain was 15.9± 7.1 at baseline and 16.4± 6.7 (p 0.48) in follow-up. Mean RA contraction strain was 9.8± 6.6 at baseline and 12.0± 6.6 at follow-up (p 0.01).

Conclusion: Right ventricular and atrial function increased in patients with RCA CTO. We find an improvement of RA and RV strain parameters after successful RCA CTO PCI.