Study of GLS in diabetic and hypertensive patients with slow flow coronary artery and compare with GLS in diabetic and hypertensive patients with normal epicardial coronary artery by 2D echocardiography

Document Type : Original Article

Authors

1 Assistant Professor, Department of Cardiology, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Cardiology, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran

Abstract

Background: Coronary slow flow phenomenon (CSF) is a microvascular disorder characterized by delayed opacification of distal branches of coronary arteries in the absence of any evidence of obstructive epicardial coronary disease.
Objective: In this study we aimed to comparing the LV global longitudinal strain (GLS) obtained by 2D- echocardiography in diabetic and hypertensive patients with slow flow coronary arteries and diabetic and hypertensive patients with normal coronary arteries.
Materials and Methods: This is a case-control study conducted on 22 diabetic and hypertensive patients with angiographically proven normal coronary arteries and slow flow in all coronary artery (TIMI frame count>27 and TIMI-2-flow) and 25 diabetic and hypertensive patients with normal coronary without slow flow phenomenon. The patients in 2 group underwent 2D echocardiography to measure LV ejection fraction, GLS and LVH.
Results: In this study, 20 women and 27 men with the average age of 55.55±11.16 (range 31 to 80 years) were enrolled. There was no significant difference in GLS between CSF and control group (-13.58 ± 5.50% versus -12.28 ± 7.03%, P<0.489). There was no significant difference between the two groups in terms of LVEF and LVH (P <0.05).
Conclusion: The GLS in diabetic and hypertensive patients with and without CSF is not different, so measurement of global longitudinal strain using 2D echocardiography is not helpfull in diagnose of CSF in this group of patients.

Keywords

References

1-Barutçu A, Bekler A, Temiz A, Kırılmaz B, Yener AÜ, Tan YZ, Gazi E, Altun B. Left Ventricular Twist Mechanics Are Impaired in Patients with Coronary Slow Flow. Echocardiography. 2015;32(11):1647-54. doi: 10.1111/echo.12918. Epub 2015 Mar 4.
2-Beltrame JF, Ganz P. The coronary slow flow phenomenon. In: Kaski JC, Eslick GD, Merz CNB, eds. Chest Pain with Normal Coronary Arteries. A Multidisciplinary Approach. London, England: Springer-Verlag; 2013:101-117.
3-Beltrame JF, Limaye SB, Horowitz JD. The coronary slow flow phenomenon—a new coronary microvascular disorder. Cardiology. 2002; 97(4): 197–202. PMID: 12145474
4-Hawkins BM, Stavrakis S, Rousan TA, Abu-Fadel M, Schechter E. Coronary slow flow-prevalence and clinical correlations. Circ J. 2012; 76: 936-942. PMID: 22293446
5-Wang Y, Ma C, Zhang Y, Guan Z, Liu S, Li Y, Yang J. Assessment of left and right ventricular diastolic and systolic functions using two-dimensional speckle-tracking echocardiography in patients with coronary slow-flow phenomenon. PLoS One. 2015 Feb 23;10(2): 0117979. doi: 10.1371/journal.pone.0117979. eCollection 2015.
6-Sanghvi S, Mathur R, Baroopal A, Kumar A. Clinical, demographic, risk factor and angiographic profile of coronary slow flow phenomenon: A single center experience, Indian Heart J. 2018. https://doi.org/10.1016/j.ihj.2018.06.001
7-Cin VG, Pekdemir H, Camsar A, Cicek D, Akkus MN, et al. Diffuse intimal thickening of coronary arteries in slow coronary flow. Jpn Heart J. 2003; 44: 907–919. PMID: 14711186
8-Baykan M, Baykan EC, Turan S, et al: Assessment of left ventricular function and Tei index by tissue Doppler imaging in patients with slow coronary flow. Echocardiography. 2009; 26:1167-1172. doi: 10.1111/j.1540-8175.2009.00939.x PMID: 19725862
9-Nurkalem Z, Gorgulu S, Uslu N, Orhan AL, Alper AT, Erer B, Zencirci E, Aksu H, Eren M. Longitudinal left ventricular systolic function is impaired in patients with coronary slow flow. Int J Cardiovasc Imaging. 2009 Jan;25(1):25-32. doi: 10.1007/s10554-008-9341-1. Epub 2008 Jul 15.
10-Altunkas F, Koc F, Ceyhan K, Celik A, Kadi H, et al. The effect of slow coronary flow on right and left ventricular performance. Med Princ Pract. 2014; 23: 34–39. doi: 10.1159/000355471 PMID: 24217066
11-Krishnasamy R, Isbel NM, Hawley CM, et al. Left Ventricular Global Longitudinal Strain (GLS) Is a Superior Predictor of All-Cause and Cardiovascular Mortality When Compared to Ejection Fraction in Advanced Chronic Kidney Disease. PLoS One. 2015;10(5):e0127044. Published 2015 May 15. doi:10.1371/journal.pone.0127044
12-Yingchoncharoen T, Agarwal S, Marwick TH, Cleveland Clinic Fundation. Normal ranges of left ventricular global longitudinal strain: A meta-analysis of 2484 subjects. Circ J. 2012;76:1550.
13-Edvardsen T, Helle-Valle T, Smiseth OA. Systolic dysfunction in heart failure with normal ejection fraction: speckle-tracking echocardiography. Prog Cardiovasc Dis. 2006; 49: 207–214. PMID:17084180.
14-Gulel O, Akcay M, Soylu K, Aksan G, Yuksel S, Zengin H, Meric M, Sahin M. Left Ventricular Myocardial Deformation Parameters Are Affected by Coronary Slow Flow Phenomenon: A Study of Speckle Tracking Echocardiography. Echocardiography. 2016 May;33(5):714-23. doi: 10.1111/echo.13146.
15-Mukhopadhyay S, Kumar M, Yusuf J, Gupta KV, Tyagi S. Risk factors and angiographic profile of coronary slow flow (CSF) phenomenon in North Indian population: An observational study. Indian Heart Journal. 2018; 70(3): 405-409.
16-Kemaloğlu Öz T, Eren M, Atasoy I, Gürol T, Soylu Ö, Dağdeviren B. Are biventricular systolic functions impaired in patient with coronoray slow flow? A prospective study with three dimensional speckle tracking. Int J Cardiovasc Imaging. 2017;33(5):675-681. doi: 10.1007/s10554-016-1054-2.
17-Alvarez C, Siu H. Coronary Slow-Flow Phenomenon as an Underrecognized and Treatable Source of Chest Pain: Case Series and Literature Review. J Investig Med High Impact Case Rep. 2018 Jan-Dec; 6: 2324709618789194.
18-Sezgin AT, Sgrc A, Barutcu I, et al. Vascular endothelial function in patients with slow coronary flow. Coronary Artery Dis. 2003; 14: 155–161.
19-Marechaux S. Speckle-tracking strain echocardiography: any place in routine daily practice in 2014? Arch Cardiovasc Dis. 2013; 106: 629–634. doi: 10.1016/j.acvd.2013.10.001. PMID: 24246615
20-Wierzbowska-Drabik K, Hamala P, Roszczyk N, et al. Feasibility and correlation of standard 2D speckle tracking echocardiography and automated function imaging derived parameters of left ventricular function during dobutamine stress test. Int J Cardiovasc Imaging. 2014; 30:729-737.
21-Abraham TP, Dimaano VL, Liang HY. Role of tissue Doppler and strain echocardiography in current clinical practice. Circulation. 2007;116:2597–2609.
22-Pekdemir H, Cin VG, Cicek D, et al. Slow coronary flow may be a sign of diffuse atherosclerosis. Contribution of FFR and IVUS. Acta Cardiol. 2004;59:127–133.
23-Radwan H, Hussein E. Value of global longitudinal strain by two dimensional speckle tracking echocardiography in predicting coronary artery disease severity, The Egypt Heart J. 2016; http://dx.doi.org/10.1016/j.ehj.2016.08.001
24-Billehaug N, Vidar R, Edvardsen T, et al. Diagnostic accuracy of left ventricular longitudinal function by speckle tracking echocardiography to predict significant coronary artery stenosis. BMC Med Ima. 2015;15:25.
25-Biering-Sørensen T, Hoffman S, Mogelvang R, et al. Myocardial strain analysis by 2-Dimensional speckle tracking echocardiography improves diagnostics of coronary artery stenosis in stable angina pectoris. Circ Cardiovasc Imag. 2014;7:58-65.
26-Gaibazzi N, Pigazzani F, Reverberi C, Porter Thomas R. Rest global longitudinal 2D strain to detect coronary artery disease in patients undergoing stress echocardiography: a comparison with wall-motion and coronary flow reserve responses. Echo Res Pract. 2014;(December):61–70.
27-Montgomery DE, Puthumana JJ, Fox JM, Ogunyankin KO. Global longitudinal strain aids the detection of non-obstructive coronary artery disease in the resting echocardiogram. Euro Heart J Cardiovasc Imag. 2012;13:579–87.
28-Nucifora G, Schuijf JD, Delgado V, Bertini M, Scholte AJ, Ng AC, et al. Incremental value of subclinical left ventricular systolic dysfunction for the identification of patients with obstructive coronary artery disease. Am Heart J. 2010;159:148–57.
29-Burns AT, La Gerche A, D’hooge J, MacIsaac AL, Prior DL. Left ventricular strain and strain rate: characterization of the effect of load in human subjects. Euro J Echocardiogr. 2010;11:283–9.
30-Choi JO, Cho SW, Song YB, Cho SJ, Song BG, Lee SC, et al. Longitudinal 2D strain at rest predicts the presence of left main and three vessel coronary artery disease in patients without regional wall motion abnormality. Euro J Echocardiogr. 2009;10:695–701.
Jundishapur Scientific Medical Journal
Volume 18, Issue 2 - Serial Number 119
July and August 2019
Pages 129-141

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History

  • Receive Date: 14 April 2019
  • Revise Date: 10 July 2019
  • Accept Date: 13 July 2019

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