Role of Coronary Computed Tomography Angiography in Assessment of Relationship between Right Coronary Artery-Aorta Angle and the Development of Right Coronary Artery Disease

Document Type : Original Article

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Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Coronary artery disease [CAD] is a major cardiovascular condition that demands accurate, timely, and cost-efficient diagnostic strategies. This research determined whether an association noted between the right coronary artery [RCA]-aorta angle and the presence of RCA-related CAD. 
Patients and Methods: A cross-sectional study was conducted on 150 patients; randomly divided into three equal groups. Group I [control] included individuals with normal coronary computed tomography angiography [CCTA]. Group II comprised patients with abnormal CCTA and <50% RCA stenosis. Group III consisted of patients with abnormal CCTA and >50% RCA stenosis, who also underwent invasive coronary angiography [CA].
Results: The RCA-aorta angle A [axial view] exhibited a significant inverse correlation with CAD [r=-0.474, P=0.000]. Additionally, systolic blood pressure and serum creatinine were negatively correlated with angle A [r=-0.229, P=0.005 and r=-0.289, P=0.000, respectively]. However, the RCA-aorta angle B [measured on multiplanar reconstruction] was not significantly associated with CAD or clinical parameters.
Conclusion: The RCA-aorta angle, as measured by CCTA, correlates significantly with RCA stenosis severity. CCTA offers a non-invasive means of anatomical assessment, and RCA-aorta angle measurement may assist in identifying patients at risk for clinically relevant RCA lesions, supporting better risk stratification and diagnostic planning in suspected CAD.

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