Interplay of coronary dominance and biventricular function: insights from speckle tracking echocardiography

Background and purpose: The relationship between coronary anatomy and ventricular function is not fully understood, particularly in the context of normal coronary dominance (CD) patterns. This study aims to use speckle tracking echocardiography (STE) to investigate biventricular function across various CD patterns. The main goal of the study is to detect and measure variations in biventricular function associated with normal CD patterns using STE. Methods: This cross-sectional study included 91 individuals with confirmed normal coronary angiography findings. Among them, 56 had right coronary dominance (RCD), 24 had left coronary dominance (LCD), and 11 had co-coronary dominance (CCD). Conventional echo-Doppler imaging and STE were used to assess left ventricular (LV) and right ventricular (RV) functions. The correlation between the CD patterns and ventricular function indices was assessed. Results: The mean age was 50.25 ± 11.03 years, with 50.5% females. No significant differences were found in demographics, risk factors, or RV function. Conventional LV function indices showed no variance, but LV global longitudinal strain (GLS) was significantly higher in LCD and CCD than in RCD (P < 0.001). The LCD pattern correlated with LV GLS ( r = −0.55, P = 0.005) and emerged as its sole independent predictor (P < 0.001). This suggests a strong association between the LCD pattern and enhanced LV GLS. Conclusions: This study highlights the potential influence of normal CD patterns on ventricular function, as assessed by STE. The LV was functionally dominant in the context of normal anatomical LCD. Meanwhile, the CD pattern had an insignificant effect on RV function.