Koroner yavaş akımı olan hastalarda sol ventrikül diyastolik fonksiyonunun konvansiyonel ve doku Doppler ekokardiyografi ile değerlendirilmesi

Öz

Amaç: Bu çalışmamızda koroner yavaş akım (KYA)\'nın sol ventrikül diyastolik fonksiyonu (SVDF) üzerine etkisini konvansiyonel ve Doppler görüntüleme (DDG) yöntemi ile araştırmayı amaçladık. Yöntemler: Çalışmaya koroner arter hastalığı şüphesi ile koroner anjiyografi yapılan, koroner arterleri normal olup KYA tespit edilen toplam 32 hasta (ortalama yaş: 55±13, 18 erkek) kontrol grubu olarak da koroner arterleri normal olan ve normal koroner akımlı 30 hasta (ortalama yaş: 50±10, 15 erkek) alındı. KYA tanısı konurken düzeltilmiş TIMI kare sayımı yöntemi kullanıldı. Tüm olguların anjiyografiden bir gün sonra konvansiyonel ve doku Doppler ekokardiyografi ile sol ventrikül diyastolik fonksiyonları değerlendirildi. Tüm veriler iki grup arasında karşılaştırıldı. Bulgular: KYA olan grupta sol ön inen arter, sirkumfleks ve sağ koroner arterler için TIMI kare sayıları anlamlı derecede yüksek bulundu (p

Anahtar Kelimeler

• Koroner yavaş akım; diyastolik fonksiyon; doku Doppler görüntüleme

Evaluation of diastolic function in patients with slow coronary flow by conventional and tissue Doppler echocardiography

Abstract

Objective: In present study, we aimed to investigate the effect of slow coronary flow (SCF) on left ventricular diastolic functions by using conventional and tissue Doppler imaging method. Methods: Thirty-two SCF patients with normal coronary artery (mean age, 55±13, 18 male), and 30 normal coronary flow patients with normal coronary artery (mean age, 50±10, 15 male) were enrolled to the study. TIMI frame count method was used for SCF diagnosis. The left ventricular diastolic functions of all participants were evaluated by conventional and tissue Doppler echocardiography one day after coronary angiography. All data were compared between two groups. Results: TIMI frame counts of left anterior descending artery, circumflex and right coronary artery were significantly higher in CSF group (p

Keywords

• Diastolic function; slow coronary flow; tissue Doppler imaging

Kaynakça

1. Tambe AA, Demany MA, Zimmerman HA, Mascar- enhas E. Angina pectoris and slow flow velocity of dye in coronary arteries--a new angiographic finding. Am Heart J 1972;84:66-71.
2. Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-888.
3. Pekdemir H, Cin VG, Ciçek D, et al. Slow coronary flow may be a sign of diffuse atherosclerosis. Contribution of FFR and IVUS. Acta Cardiol. 2004;59:127-133.
4. Beltrame JF, Limaye SB, Wuttke RD, Horowitz JD. Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon. Am Heart J 2003;146:84-90.
5. Harizi RC, Bianco JA, Alpert JS. Diastolic function of the heart in clinical cardiology. Arch Intern Med 1988;148:99-109.
6. Galderisi M. Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic as- pects. Cardiovasc Ultrasound 2005;3:9.
7. Sutherland G, Hatle L.Pulsed Doppler myocardial im- aging. A new approach to regional longitudinal func- tion. Eur J Echocardiograhy 2000;1:81-83.
8. Nagueh SF, Middleton KJ, Kopelen HA, et al. Doppler tissue imaging: a noninvasive technique for evalu- ationof left ventricular relaxation and estimation of fill- ing pressures. J Am Coll Cardiol 1997;30:1527-1533.

9. Waggoner AD, Bierig SM. Tissue Doppler imaging: a useful echocardiographic metod for the cardiac so- nographer to assess systolic and diastolic ventricular function. J Am Soc Echocardiogr 2001;14:1143-1152.
10. Cesar LA, Ramires JA, Serrana Junior CV, Meneghe- tti JC, et al. Slow coronary runoff in patient with angina pectoris: clinical significance and thalium-201 scinti- graphic study. Braz Med Biol Res 1996;29:605-613.
11. Beltrame JF, Limaye SB, Horowitz JB. The coronary slow flow phenomenon –a new coronary microvascu- lar disorder. Cardiology 2002;97:197-202.
12. Tebbe U, Neuhaus KL, Kreuzer H. Slow flow in the cor- onary artery system and ST elevation in the ECG in the left atrium catheterization. Z Kardiol 1984;73:789- 791.
13. Kapoor A, Goel PK, Gupta S. Slow coronary flow - a cause for angina with ST elevation and normal coro- nary arteries. A report. Int J Cardiol 1998;67:257-261.
14. Cin VG, Pekdemir H, Camsari A, et. al. Diffuse intimal thickening of coronary arteries in slow coronary flow. Japan Heart J 2003;44:907-919.
15. Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocar- diography is the clinician’s Rosetta Stone. J Am Coll Cardiol 1997;30:8-18.
16. Sezgin AT, Topal, Barutcu I et all. Impaired left ventri- cle filling in slow coronary flow phenomenon: an echo- Doppler study. Angiologi 2005;56:397-401.
17. Choong CY, Abascal VM, Thomas JD, et. all. Com- bined influence of ventricular loading and relaxation on the transmitral flow velocity profile in dogs mea- sured by Doppler echocardiography. Circulation 1998; 78: 672-83.
18. Thomas JD, Weyman AE. Echocardiographic Doppler evaluation of left ventricular diastolic function. Physics and physiology. Circulation 1991;84:977-999.
19. Farias C, Rodriguez L, Garcia M, et. all. Assesment of diastolic function by tissue Doppler echocardiography: Comparison with Standard transmitral and pulmonary venous flow. J Am Soc Echocardiogr 1999;12:609- 617.
20. Garcia-Fernandez MA, Azevedo J, Moreno M, et al. Regional diastolic function in ischaemic heart disease using pulsed wave Doppler tissue imaging. Eur Heart J 1999;20:496-505.
21. Altunkas F, Koc F, Ceyhan K, et al. The effect of slow coronary flow on right and left ventricular perfor- mance. Med Princ Pract 2014;23:34-39.
22. Elsherbiny IA. Left ventricular function and exercise capacity in patients with slow coronary flow. Echocar- diography 2012 Feb;29:158-164.
23. Zencir C, Cetin M, Güngör H, et al. [Evaluation of left ventricular systolic and diastolic functions in patients with coronary slow flow phenomenon]. Turk Kardiyol Dern Ars 2013 Dec;41:691-696.
24. Tekin ve arkadasları. Yavas Koroner Akımı Olan Has- talarda Sol ventrikül Diyastolik Fonksiyonlarının De- gerlendirilmesi: Bir Doku Doppler Çalısması. MN Car- diology 2007;14:230-235
25. Oguzhan A, Abacı A, Eryol NK ve ark. Doku Doppler görüntülemesi: sol ventrikül diyastol sonu basıncının tahmininde noninvazif bir teknik. Türk Kardiyol Dern Ars 2000;28:82-87.
26. Garcia MJ, Ares MA, Asher C, et al. Color M mode flow velocity propagation: an index of early left ven- tricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure. J Am Coll Cardol 1997;29:448-454.
27. Sohn DW, Song JM, Zo JH, et al. Mitral annulus velocity in the evaluation of left ventricular diastolic function in atrial fibrillation. J Am Soc Echocardiogr 1999;12:927-931.