Assessment of Left Ventricular Functions by Two-Dimensional Speckle Tracking Echocardiography in Patients with Coronary Slow-Flow Phenomenon.

Abstract

Background: Coronary slow flow phenomenon (CSFP) is a medical challenge, especially regarding its diagnosis. The use of speckle tracking seems to provide a clue for diagnosis. However, its role is not well addressed.
 Aim of the work: To assess the value of the left ventricle's global longitudinal strain by 2D speckle tracking to detect subclinical left ventricular systolic dysfunction in patients with the slow coronary flow.
 Patients and methods: This study was performed between May and September 2020 at the cardiology department, Al-Azhar University Hospital (New Damietta). Thirty patients are known to have slow coronary flow based on a previous coronary angiographic examination, and 30 healthy participants with the same demographic match (age and sex) as a control group were included. Patients were classified into two groups: Group (A): Included 30 patients with a coronary slow flow. Group (B): Included 30 normal healthy adult persons served as a control group. All were assessed clinically and by radiological investigations. In addition, speckle tracking echocardiography was done for all patients.
 Results: In Doppler flow measures, E wave and E/A ratio showed significantly lower values in CSFP when compared with the control group (p= 0.02, 0.003 respectively). According to tissue velocity imaging (TVI), there is a similarity between both groups without any significant difference. Speckle tracking measurements demonstrate significantly lower value in patients with CSFP than the control group (p=0.003).
 Conclusion: In patients with CSF, LV systolic function detected during both conventional and tissue Doppler echocardiographic examinations was not affected, but 2D longitudinal strain demonstrated that LV systolic function was impaired. CSFP could impair LV diastolic function.