Background: Optimal cardiac performance relies on integrity between left ventricle (LV) and right ventricle (RV) owing to variety of factors as shared coronary circulation. RV systolic dysfunction identified as a poor prognostic factor. Objectives: We aimed at assessing the impact of LV ischemia on RV performance in occurrence or absence of right coronary artery (RCA) disease. Subjects and methods: We enrolled 40 patients with proven LV ischemia. All patients were subjected to myocardial perfusion imaging and coronary angiography. LV and RV functional parameters were assessed in all individuals using conventional echocardiography, tissue Doppler imaging (TDI), two-dimensional speckle tracking echocardiography (2D-STE) and 4-dimensional echocardiography (4DE). 
Results: We divided our patients based on presence or absence of angiographic significant RCA disease into two groups. Group I with RCA involvement (22 patients) and Group II without significant RCA involvement (18 patients). Group I was older, predominantly men and more hypertensive (HTN) compared to Group II, however it did not reach statistical significance. Our study demonstrated reduced RV performance in both groups however, it didn't reach the statistical significance.
Conclusion: RV performance was impaired in ischemic heart disease (IHD) but not significantly affected by the presence or absence of RCA affection, denoting that the right ventricular performance is directly interdependent on the left ventricular function in ischemic heart disease.