Effects Of Coronary Slow Flow On Left Atrial Function

Objective: The Coronary slow flow phenomenon(CSFP)is a well recognized angiographic clinical entity,characterized by delayed distal vessel pacification in the absence of significant epicardial coronary disease.Exact pathphysiologic mechanisms of slow coronary flow have not yet been established.Early sign of atherosclerosis,microvascular dysfunction,platelet function disorder and hemorheology were reported to be associated with CSFP.Endothelial dysfunction and Inflammation may play a key role in pathophysiologic mechanisms of CSFP.Currently,several investigators are focusing on ventricular function assessment in patients with CSFP,however,there is a paucity of data on their atrial function.Two-dimensional speckle tracking technology(2D-STE)is a quantitative technique for accurately evaluating myocardial function.By analyzing the motion of speckles identified on routine 2-dimensional sonograms,strain and the strain rate can be precisely measured offline after adequate image acquisition.In this study,we aimed to assess the relationship between the risk factors and CSFP,we also performed to evaluate the effects of CSFP on Atrial Function using Two-Dimensional Speckle Tracking Echocardiography(2D-STE).Method: From January 2016 to September 2017,a total of 101 patients were consecutively enrolled in the study.Those with corrected thrombolysis in myocardial infarction frame count(TFC)exceeding 27 in one or more vessels were allocated to the CSF group,based on the diagnostic criteria of patients with slow flow of coronary artery in C irculation Journal in 2012.139 patients with normal coronary flow were included in the control group.Data collection including gender,age,height,weight,systolic blood pressure,diastolic blood pressure,heart rate,etc.The related biochemical indexes including blood routine,liver and kidney function,c-reactive protein and homocysteine,etc.All patients underwent echocardiography of Phillips Medical System s5-1 in 24 hours before coronary angiography.Included indicators such as structure measurement and Mitral Valve Flow Pattern and tissue spectrum.The left atrial strain and strain rate of two groups were measured by 2D-STE in the offline workstation(Q lab10.5,Phillips Medical System).Result: 1.The TFC-LAD(P<0.001),TFC-LCX(P<0.001),TFC-RCA(P<0.001)?c TFC-LAD(P<0.001),m TFC(P<0.001)was significantly higher in the CSF group as compared to the controls.The distributions of age(P=0.66),sex(P=0.46),hypertension(P=0.94),diabetes(P=0.07),body mass index(BMI)(P=0.07)were similar between the two groups.The smoking(P<0.001)were significantly higher in the CSFP group.2.The monocyte count(P=0.007),absolute monocyte(P=0.034),hemoglobin(P=0.008),HTC(P=0.005),MCH(P=0.021),LDL(P < 0.001),CHO(P < 0.001)were significantly higher in the CSF group.In logistic regression analysis,monocyte count was found as independently associated with the presence of CSF(P=0.36).3.The analysis of left ventricular and atrial deformation parameters showed LV-m GLS(P=0.019),LV-m SRa(P=0.020),LATEF-2D(P=0.041),LA-m GLS(P=0.016),LA-m SRa(P=0.031)were significantly lower in the CSF group compared to the control group.LA-ap(P=0.048),S'(P=0.022)?LAVmin-2D(P=0.001)were significantly higher in the CSF group.Additionally,there was a strong negative correlation between mean TIMI frame count and LA-m GLS in patients with SCF(P<0.05).Conclusion:Monocyte count can be considered independent predictor of Coronary slow flow phenomenon;LA global longitudinal systolic function dec reased in patients with CSFP,there was a strong negative correlation between mean TIMI frame count and LA-m GLS.