Abstract
ObjectiveCoronary slow-flow phenomenon (CSFP) is an angiographic diagnosis characterised by a low rate of flow of contrast agent in the normal or near-normal epicardial coronary arteries. Many of the patients with CSFP may experience recurrent acute coronary syndromes. However, current clinical practice tends to underestimate the impact of CSFP due to the yet unknown effect on the cardiac function. This study was performed to evaluate left ventricular (LV) and right ventricular (RV) diastolic and systolic functions, using two-dimensional (2D) longitudinal strain and strain rate, in patients with CSFP, and to determine the relationships between the thrombolysis in myocardial infarction (TIMI) frame count (TFC) and LV and RV diastolic and systolic functions.MethodsSixty-three patients with CSFP and 45 age- and sex-matched controls without CSFP were enrolled in the study. Diagnosis of CSFP was made by TFC. LV and RV diastolic and systolic functions were assessed by 2D speckle-tracking echocardiography.ResultsLV peak early diastolic longitudinal strain rate (LSRe) was lower in patients with CSFP than in controls (P = 0.01). LV peak systolic longitudinal strain (LS) and LV peak systolic longitudinal strain rate (LSRs) were lower in patients with CSFP than in controls (P = 0.004 and P = 0.03, respectively). There was no difference in LV ejection fraction. RV peak early diastolic longitudinal strain rate (RSRe) was lower in patients with CSFP than in controls (P = 0.03). There were no differences in RV peak systolic longitudinal strain (RS), RV peak systolic longitudinal strain rate (RSRs), or RV fractional area change among the groups. The mean TFC correlated negatively with LSRe and RSRe in patients with CSFP (r = −0.26, P = 0.04 and r = −0.32, P = 0.01, respectively).ConclusionsLV diastolic and systolic functions were impaired in patients with CSFP. CSFP also affected RV diastolic function, but not RV systolic function.
Highlights
Coronary slow-flow phenomenon (CSFP), initially reported by Tambe et al [1] in 1972, is a relatively rare angiographic finding observed in patients with normal or near-normal coronary arteries
There was no difference in left ventricular (LV) ejection fraction
LV diastolic and systolic functions were impaired in patients with CSFP
Summary
Coronary slow-flow phenomenon (CSFP), initially reported by Tambe et al [1] in 1972, is a relatively rare angiographic finding observed in patients with normal or near-normal coronary arteries. Two-dimensional speckle-tracking echocardiography (2D-STE) is a novel technique enabling more reliable and comprehensive assessment of myocardial function by obtaining the myocardial strain and strain rate in longitudinal, radial, and circumferential directions based on the tracking of speckles in grayscale 2D echocardiographic images [8], [9]. This modality negates the need for parallel alignment of the ultrasound beam to myocardial wall motion. In the present study we aimed to evaluate LV and RV diastolic and systolic functions by measuring longitudinal strain and strain rate using 2D-STE in patients with CSFP. To date this is the first study to explore this topic using this method
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