Key result
Slow coronary flow was associated with impaired left ventricular function, demonstrated by a significantly higher Tei index compared to controls (0.34 vs 0.29; P=0.02).
Why the study?
Does tissue Doppler imaging detect impaired left ventricular function in patients with slow coronary flow compared to controls?
Observational (n=77)
Does tissue Doppler imaging detect impaired left ventricular function in patients with slow coronary flow compared to controls?
Tissue Doppler imaging reveals impaired left ventricular systolic and diastolic function in patients with slow coronary flow, which correlates with TIMI frame count.
May support tissue Doppler evaluation for subclinical LV impairment in slow coronary flow; extends observational associations but leaves clinical impact open.
BACKGROUND: The aim of this study was to assess left ventricular (LV) function and the Tei index by tissue Doppler imaging (TDI), and also to evaluate the relationship of thrombolysis in myocardial infarction (TIMI) frame count (TFC) with the Tei index and LV function in patients with slow coronary flow (SCF). METHODS: We prospectively evaluated 50 patients with SCF and 27 control subjects. Diagnosis of SCF was made by TFC. LV systolic and diastolic function was assessed by conventional echocardiography and TDI. RESULTS: Early diastolic mitral annular velocity (Em), Em/Am, and peak systolic mitral annular velocity (Sm) were lower in patients with SCF than those in controls (13+/-2.8 cm/sec vs 15.2+/-2.8 cm/sec, P = 0.002; 0.88+/-0.22 vs 1+/-0.23, P = 0.03; and 14.1+/-3.51 vs 16.5+/-3.31, P = 0.005, respectively). In patients with SCF, the Tei index was significantly higher than that in controls (0.34+/-9.6 vs 0.29+/-9.5, P = 0.02, respectively). Mean TFC and RCA TFC were positively correlated with the Tei index (r = 0.3, P = 0.02 and r = 0.329, P = 0.02). Left circumflex (LCX) TFC was negatively correlated with Em/Am (r =-0.310, P = 0.03) only in patients with SCF. CONCLUSION: LV systolic and diastolic function is impaired in patients with SCF. TDI analysis of mitral annular velocities such as the Tei index, Em, Em/Am, and Sm is useful to assess LV systolic and diastolic dysfunction in patients with SCF. Mean TFC and RCA TFC were positively correlated with the Tei index and LCX TFC was negatively correlated with Em/Am. TDI may be better than conventional echocardiography in assessing LV function in patients with SCF.
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Baykan et al. (2009) conducted an observational in Slow coronary flow (n=77). Slow coronary flow vs. Control subjects was evaluated on Tei index (p=0.02). Slow coronary flow was associated with impaired left ventricular function, demonstrated by a significantly higher Tei index compared to controls (0.34 vs 0.29; P=0.02).
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