The Effect of Slow Coronary Flow on Right and Left Ventricular Performance

Abstract

Objective: To evaluate left and right ventricular functions using tissue Doppler echocardiography (TDE) and myocardial performance index (MPI) methods in patients with slow coronary flow (SCF) and to determine the relationship between these parameters and thrombolysis in myocardial infarction frame count in SCF patients. Subjects and Methods: Thirty-five patients (20 males and 15 females) with SCF who underwent coronary angiography and 35 age- and sex-matched controls (14 males and 21 females) without SCF who underwent elective coronary angiography were enrolled in the study. Left ventricular (LV) and right ventricular (RV) functions were examined using conventional echocardiography and TDE. Results: LV systolic myocardial velocity (Sm), early myocardial velocity (Em), late myocardial velocity (Am), and Em/Am ratio were similar in both the SCF and control groups; however, isovolumetric relaxation time (IRT) was higher in the SCF group compared to the control group (IRT: 99 ± 17 vs. 88 ± 20; p = 0.01). In patients with SCF, LV MPI was higher than in the control group, but this was not statistically significant (0.61 ± 0.11 vs. 0.56 ± 0.12; p = 0.07). The RV tricuspid annular velocities and MPI were similar in the SCF and control groups. Conclusion: This study showed that SCF affected LV functions echocardiographically and could cause partially reduced LV performance. In addition, SCF did not affect RV functions echocardiographically.

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.…”

“…Accordingly, if we had measured these indices in all of the mitral annulus walls, our results could have been modified. In some studies, the Tei index and isovolumic relaxation time were measured by tissue Doppler imaging 13 , 14 , 16 , 17 . These studies showed that the isovolumic relaxation time in patients with the coronary slow flow phenomenon was greater than that in control groups, but their results concerning the Tei index were different.…”

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

“…Altunkas ve ark. KYA hastalarında konvansiyonel ve DDG ile sağ ve sol ventrikül performanslarını değerlendirmiş ve KYA'nın sağ ventrikül performasını etkilemezken, SV performansını kısmı olarak azaltığını göstermişlerdir [21]. Elsherbiny DDG ile KYA hastalarında SV sistolik ve diyastolik fonsiyonunun bozulduğunu göstermiş ve bu hastalarda azalmış egzersiz kapasitesi ile yavaş akım arasında negatif bir ilişki tespit etmiştir [22].…”

Retinal fluorescein angiography: A sensitive and specific tool to predict coronary slow flow

“…It is characterized by delayed opacification of coronary arteries during angiography and was initially reported in 1972 by Tambe et al 1 The frequency of CSF is approximately 1–5% in patients undergoing coronary angiography. More than 80% of patients with CSF often experience recurrent chest pain; almost 20% require readmission following the same diagnosis 2 . Also, CSF has been linked to parameters of poor prognosis, including fatal arrhythmias and sudden cardiac death 2 .…”

“…More than 80% of patients with CSF often experience recurrent chest pain; almost 20% require readmission following the same diagnosis 2 . Also, CSF has been linked to parameters of poor prognosis, including fatal arrhythmias and sudden cardiac death 2 . It is still not clear whether or not the coronary slow flow is a focal or a systemic disturbance of the vasculature that may occur simultaneously in other territories of the circulation 3 …”