Subclinical myocardial dysfunction in coronary slow flow phenomenon: Identification by speckle tracking echocardiography

Abstract

Objective This study aimed to determine whether STE could help detect subclinical myocardial dysfunction in patients with CSFP. Methods Sixty patients with CSFP confirmed by CAG and 51 controls with normal coronary flow were prospectively enrolled. Coronary angiographic data and conventional and speckle tracking echocardiographic parameters of the LV and RV were obtained for every subject. Results Compared with controls, CSFP patients presented with higher BMI and TG levels, but lower HDL‐C levels. Conventional echocardiographic parameters of biventricular systolic and diastolic function did not differ between the two groups (all P > 0.05). The GLS of the LV and RV was significantly impaired in CSFP patients compared with that in controls (−19.03% vs −21.42%, P < 0.001 and −19.72% vs −22.96%, P = 0.001, respectively). The myocardial impairment pattern of CSFP patients was homogenous in the RV and heterogeneous in the LV, where only endo‐ and mid‐myocardial layers were affected. LV‐GLS and RV‐GLS were found to be well correlated with mTFC and HDL‐C in CSFP groups (r = 0.463 vs r = 0.439; r = −0.569 vs r = −0.552, all P < 0.05). ROC curve analysis demonstrated that LV‐GLS‐endo had the highest AUC (0.867, P < 0.001) for predicting subclinical myocardial impairment in CSFP patients. Conclusions Subclinical myocardial systolic dysfunction occurs in both ventricles, and GLS could be an effective method to detect early‐stage myocardial impairment in patients with CSFP.

Machine learning to predict no reflow and in-hospital mortality in patients with ST-segment elevation myocardial infarction that underwent primary percutaneous coronary intervention

“…A recent study confirmed that the low serum albumin level at admission is an independent predictive factor for NR following pPCI in STEMI patients [ 29 ]. The coronary slow flow phenomenon is present in patients with lower high-density lipoprotein cholesterol (HDL-C) but higher BMI and TG levels [ 30 ]. An independent study confirmed that the atherogenic index of plasma (logTG/HDL-C) is independently associated with NR [ 15 ].…”

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

“…Before a diagnosis of coronary slow flow (CSF) can be made, other potential causes must first be excluded. These include medical conditions, such as severe coronary artery stenosis, coronary artery spasm, and gas embolism, as well medical treatments that might produce this phenomenon, including coronary angioplasty and thrombolytic therapy Original Article A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow Xiaobing Zhang 1 , Jiandong Ding 2 , Siliang Xia 1 (5,6). Patients with CSF experience unexplained recurrent chest pain symptoms (7)(8)(9).…”

Evaluation of cardiac chamber functions by speckle‐tracking echocardiography in the presence of coronary artery flow disturbances other than stenosis: A review

“…Among 12 studies that measured global longitudinal systolic strain (GLSS) by 2D‐STE in all myocardial segments and full myocardial thickness and/or 3D‐STE without considering the myocardial layer, nine reported declined GLSS values in patients with CSFP 27,29–31,33,35,39–41,43,44,51 . Some studies measured GLSS based on all myocardial layers (endocardial, midmyocardial, and epicardial layers) 32,38,51 .…”