Turk Kardiyol Dern Ars. 2011; 39(1): 29-34

The association of coronary slow flow with time to peak systolic strain

Enbiya Aksakal, Yahya İslamoğlu, Ziya Şimşek, Mehmet Ali Elbey, Serdar Sevimli, Şakir Arslan, Fuat Gündoğdu, Hüseyin Şenocak
Department Of Cardiology, Faculty Of Medicine, Atatürk University, Erzurum

OBJECTIVE
Time of tissue deformation is an important role in regional myocardial contractile function. The aim of this study was to evaluate the effect of coronary slow flow (CSF) on time to peak systolic strain (Ts).
Study Design: The study included 25 patients who had CSF pattern in coronary angiogram and 20 controls who had normal coronary angiogram. ‘TIMI frame count (TFC)’ methods were used for the detection of CSF. Echocardiographic recordings were obtained from standard apical/parasternal views. Color Doopler myocardial imaging (CDMI) data were acquired at 160-200 s-1 frame rates. Ejection fraction (EF) was measured by Simpson’s rule. Ts were measured from basal, mid and apical segments of all left ventricular walls.

RESULTS
There was no difference between patients and controls for left ventricular systolic functions (EF; 67±5 vs. 66±4, respectively). TFC values were greater in the patients than in the controls (LAD: 42.80±7.65 vs. 17.90±3.46; Cx: 37.68±6.49 vs. 16.60±2.90; RCA: 41.20±6.37 vs. 17.30±2.69; respectively, p<0.001 for all). There were significant differences between patients and controls for Ts, in 18 segments to left ventricle (p<0.001). Mean Ts were shorter in most of the mid segments compared with basal segments (p<0.05) in same walls of patients and controls. There were no differences in mean Ts between the mid and apical segments in all subjects.

CONCLUSION
Our study is the first to demonstrate the coronary slow flow induced prolongation of the time to peak systolic strain. This condition might be an additional factor to deterioration of regional myocardial contractile function in CSF patients.

Keywords: Blood flow velocity, coronary angiography; coronary circulation / physiology; Echocardiography, Doppler / methods; myocardial contraction / physiology; systole / physiology; ventricular function, left / physiology.

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