Longitudinal left ventricular systolic function is impaired in patients with coronary slow flow

Abstract

Slow coronary flow (SCF) is a well recognized clinical entity, characterized by delayed opacification of coronary arteries in the presence of normal coronary angiogram. There is currently no data evaluating myocardial systolic function in SCF phenomenon. This study was performed to evaluate regional and global systolic function using tissue Doppler imaging (TDI), strain (S) and strain rate imaging (SRI) in patients with slow coronary flow. A total of 35 patients with slow coronary flow and otherwise normal coronary arteries (mean age 48 +/- 7 years) (SCF group) and 21 patients with normal coronary angiograms (mean age 50 +/- 12 years) (control group) were included in the study. These patients were prospectively assessed for evaluation of regional and global left ventricular function by conventional echocardiography, systolic TDI, peak S, and peak systolic strain rates (SRs) There was a significant difference in peak SRs (-1.1 +/- 0.2 vs. -1.8 +/- 0.2 1/s, P < or = 0.0001) but similar in systolic TDI (42 +/- 20 vs. 44 +/- 21 mm/s, P = 0.77) and S (20.7 +/- 7.7 vs. 23.7 +/- 8.8, P = 0.14) between groups. SRs showed a good correlation with mean TIMI frame count (r = -0.80, P < or = 0.0001). As the number of coronary artery with SCF increased global strain rate decreased further. In case of one or two or three coronary artery with SCF global strain rates were 1.4 +/- 0.2; 1.1 +/- 0.3; 0.9 +/- 0.2 1/s, respectively, P < or = 0.0001. Although ejection fraction was preserved, global and regional strain rate were decreased in SCF. In brief, there is an impairment in longitudinal left ventricular systolic function in patients with SCF.

Effect of Coronary Slow Flow on the Longitudinal Left Ventricular Function Assessed by 2‐Dimensional Speckle‐Tracking Echocardiography

“…Studies on tissue Doppler imaging (pulsed wave or color coded) indices in patients with the coronary slow flow phenomenon have yielded different results. Although all of these studies were in agreement regarding a′ inasmuch as they reported no difference between patients with the coronary slow flow phenomenon and control groups, some of them showed that s′ and e′ were different between the groups, 13 , 14 , 17 , 18 , 24 and others revealed no difference between the groups 15 , 16 , 19 , 20 . As mentioned above, our results showed that s′ and e′ were different between our study groups.…”

Left Ventricular Twist Mechanics Are Impaired in Patients with Coronary Slow Flow

“…1 Although various mechanisms have been suggested for the pathogenesis of CSF, the pathophysiology and clinical implications of CSF are not clearly understood. [5][6][7] However, the effect of CSF on left ventricular twist functions has not been assessed. Recent two-dimensional speckle tracking echocardiography (STE) and Doppler studies have shown that CSF results in systolic and diastolic dysfunctions.…”

Evaluation of two-dimensional strain rate imaging on left ventricular longaxis systolic function in patients with slow coronary flow

“…Therefore, myocardial longitudinal systolic strain rate was the sensitive index in ischemia myocardial, which represented the maximum deformation degree of systole and the contractibility. Recently, the left ventricular longitudinal strain were reported that its significance in the early detection of ischemia myocardial dysfunction in sub-endocardial myocardial, as well as the sensitive index of myocardial contractility of left ventricle [11][12][13][14].…”