Evaluation of diastolic function in patients with slow coronary flow by conventional and tissue Doppler echocardiography

Abstract

Objective: In present study, we aimed to investigate the effect of slow coronary flow (SCF) on left ventricular diastolic functions by using conventional and tissue Doppler imaging method.Methods: Thirty-two SCF patients with normal coronary artery (mean age, 55±13, 18 male), and 30 normal coronary flow patients with normal coronary artery (mean age, 50±10, 15 male) were enrolled to the study. TIMI frame count method was used for SCF diagnosis. The left ventricular diastolic functions of all participants were evaluated by conventional and tissue Doppler echocardiography one day after coronary angiography. All data were compared between two groups.Results: TIMI frame counts of left anterior descending artery, circumflex and right coronary artery were significantly higher in CSF group (p<0.01). There were significant decrease in early and late diastolic maximum filling rates (E/A) (p<0.01), and significant prolongation at early deceleration time (p<0.01) on conventional echocardiography in CSF group. The tissue Doppler parameters which have been measured from the four region of mitral annulus were as follows: the mean Em velocity and mean Em/Am ratio were significantly lower in CSF patients (p<0.01), and mean Am velocity were significantly higher (p<0.01). E/Em, a non-invasive predictor of left ventricular filling pressures, is similar in both groups. Bulgular: KYA olan grupta sol ön inen arter, sirkumfleks ve sağ koroner arterler için TIMI kare sayıları anlamlı derecede yüksek bulundu (p<0.01). Konvansiyonel ekokardiyografide KYA grubunda erken ve geç diyastolik doluş maksimum hızlarının oranında (E/A) anlamlı derecede bir azalma (p<0.01) ve erken deselerasyon zamanında anlamlı bir uzama tespit edildi (p<0.01). Hastaların sol ventrikül mitral halkanın dört bölgesinden alınan doku Doppler parametrelerinde; KYA olan grupta ortalama Em velositesi ile ortalama Em/Am değerinin anlamlı olarak azaldığı gözlenirken (sırası ile p<0.01 ve p<0,01), ortalama Am velositesinin anlamlı derecede arttığı görüldü (p<0,01). Sol ventrikül doluş basınçlarının noninvaziv bir prediktörü olan E/Em oranı her iki grupta benzer olarak bulundu. Sonuçlar: Sol ventrikül bölgesel ve global diyastolik fonksiyonu koroner yavaş akımlı hastalarda normal olgulara kıyasla anlamlı oranda bozulmuştur. ConclusionAnahtar kelimeler: Koroner yavaş akım; diyastolik fonksiyon; doku Doppler görüntüleme