Relation Between Left Atrial Strain Function and Coronary Slow Flow Phenomenon Using Two-Dimensional Speckle-Tracking Echocardiography

Yıl 2018, Cilt: 21 Sayı: 1, 21 - 25, 01.04.2018

Fatih Mehmet Uçar , Mustafa Adem Yılmaztepe

Öz

Introduction: Coronary
slow flow (CSF) phenomenon is a clinical entity characterized by a slow, opaque
material reaching distal coronary arteries in patients with normal or
noncritical coronary artery diseases. Strain imaging techniques are reliable
methods for evaluating both global and regional cardiac functions. In this
study, we planned to investigate the relationship between left atrial strain
(LAS), which is the best noninvasive demonstrator of left ventricle diastolic
dysfunction, and CSF.

Patients and Methods:
Thirty-eight
consecutive patients whose coronary angiography was performed and CSF was
detected at our hospital between January and December 2016 were included in the
study. Thirty-seven age and sex matched patients with normal coronary arteries
were enrolled as a control group.

Results: The median
age was 52 ± 10.4 years, and 54.1% patients were male. Peak atrial longitudinal
strain and peak atrial contraction strain were lower in the CSF group than in
the control group (32.84 ± 8.06 vs. 38.49 ± 6.42, p= 0.001 and p< 0.001,
respectively). In addition, time to peak longitudinal strain was higher in CSF
group when compared with control group (445 ± 58 vs. 407 ± 36, p= 0.001,
respectively).

Conclusion: It is known that there is a
relationship between CSF and diastolic dysfunction and it is also known that
LAS, which can be measured using the speckle-tracking method, shows left
ventricle filling pressure like invasive measurements. In this study, we found
an association between LAS, which is an easily available, cheap, and
noninvasive method, and CSF.

Anahtar Kelimeler

Speckle tracking, left atrial strain, coronary slow flow

İki Boyutlu Ekokardiyografik Speckle Tracking ile Değerlendirilen Sol Atriyal Strain Parametresinin Koroner Yavaş Akım Fenomeni ile İlişkisi

Öz

Giriş: Koroner yavaş akım (KYA) fenomeni anjiyografik olarak
koroner arterleri normal olan veya tıkayıcı kritik darlığı olmayan hastalarda
koroner anjiyografi sırasında distal koroner arterlere opak madde ulaşmasının
yavaş olmasıdır. Gerilim (strain) görüntülemesi tekniği hem global hem de
bölgesel kalp fonksiyonları değerlendirmesinde oldukça güvenilir bir yöntemdir.
Bu çalışmada sol ventrikül diyastolik disfonksiyonunun en iyi girişimsel
olmayan göstericisi olan sol atriyal strain değeri ile koroner yavaş akım
arasındaki ilişkiyi araştırmayı planladık.

Hastalar ve Yöntem: Hastanemizde Ocak 2016 ve Aralık
2016 tarihleri arasında koroner anjiyografi yapılmış ve KYA saptanan ardışık 38
hasta çalışmaya alınmıştır. Yaş ve cinsiyet açısından çalışma grubu ile
benzerlik  gösteren ve normal koroner
arterler saptanan 37 hasta ise kontrol grubu olarak çalışmamıza dahil
edilmiştir. 

Bulgular: Hastaların yaş ortalaması 52 ± 10.4 ve erkek cinsiyet
oranı %54.1’dir. Kontrol grubu ile kıyaslandığında global pik atriyal
longitidunal strain (PALS) ve pik atriyal kontraksiyon strain (PACS)
değerlerinin KYA grubunda azaldığını bulduk (32.84 ± 8.06’ya karşı 38.49 ±
6.42, p= 0.001 ve < 0.001, sırasıyla). Bununla birlikte pik longitidunal
straine ulaşma süresi (TPLS)’nin koroner yavaş akım tespit edilen hastalarda
daha uzun olduğunu tespit ettik (445 ± 58’e karşı 407 ± 36, p= 0.001).

Sonuç: Koroner yavaş akım ile sol
ventrikül diyastolik disfonksiyonun ilişkili olduğu ve speckle trecking yöntemi
ile ölçülen sol atriyal strain değerinin invaziv ölçümler kadar sol ventrikül
doluş basıncını gösterdiği bilinmektedir. Biz çalışmamızda kolaylıkla uygulanabilen,
ucuz ve  girişimsel olmayan bir yöntem
olan sol atrial strain parametresi ile 
koroner yavaş akım arasında pozitif bir ilişki saptadık.

Anahtar Kelimeler

Speckle tracking, sol atriyal strain, koroner yavaş akım

Kaynakça

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