Authors:

Uyen Dang

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Background: Retrograde flow detected using noninvasive imaging modalities has been associated with the severity of coronary artery occlusive lesions, possibly reflecting a hemodynamic disturbance such as the water hammer shock phenomenon. However, no study to date has investigated reverse flow using conventional invasive coronary angiography (ICA) as an indicator for coronary artery lesions. This study aimed to evaluate the correlation between the presence of reverse flow and the severity of right coronary artery (RCA) lesion. Methods: A cross-sectional study was conducted on 30 patients with unstable angina who underwent ICA. Reverse flow was defined as increased contrast attenuation in the RCA at the end of the diastolic phase. Lesion severity was categorized as no lesion (0%), mild (1-39%), moderate (40-69%), and severe (?70%). The chi-square test was used to evaluate the association between the reverse flow and severity of RCA lesions. Results: Among 30 patients, 21 (70%) had right coronary artery (RCA) obstruction and 4 (13.33%) had thick boundary layer. End-diastolic flow reversal on ICA was observed in 23 patients (76.7%). Nearly 93% patients with moderate RCA lesions exhibited reverse end-diastolic flow, compared to 60-66% in patients with mild or no RCA lesions. There were 4 patients without RCA lesions demonstrated reverse flow on ICA; indicating that reverse flow may precede detectable coronary obstruction. Conclusions: This study suggests a potential positive correlation between retrograde flow and RCA lesion severity. Distal end-diastolic reverse flow may reflect early hemodynamic changes and could potentially serve as an indicator of the severity of coronary artery disease. † Presenting Undergrad Author; ‡ Contributing Undergrad Author; * Undergrad Acknowledgment Keywords: Right Coronary Artery; Retrograde Flow; Invasive Coronary Angiography; Occlusive Lesion; Coronary Artery Disease

Source:

Purdue University / 2025

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Uyen Dang