Left Ventricular Twist Mechanics Are Impaired in Patients with Coronary Slow Flow.
OBJECTIVE
Coronary slow flow (CSF) is a rare condition described as the delayed angiographic passage of a contrast agent in the absence of stenosis in epicardial coronary arteries. Left ventricular (LV) systolic and diastolic dysfunctions have been described in the presence of CSF. However, the effect of CSF on LV twist functions has not been assessed. We aimed to evaluate the effects of CSF on LV twist mechanics using speckle tracking echocardiography (STE).


METHODS
Twenty CSF patients (24-60 years) were enrolled according to the exclusion criteria. Twenty subjects with similar demographic characteristics and normal coronary arteries were the controls. Participants were evaluated with conventional echocardiography and STE.


RESULTS
The general characteristics of the two groups were similar. LV twist, LV torsion, and apical rotation were impaired in the CSF group (P = 0.015, P = 0.012, and P < 0.001, respectively). Time to peak twist (TPT) and time to peak untwisting (TPU) were prolonged in CSF patients (P < 0.001 and P < 0.001, respectively). In the CSF group, rotation-deformation delay was shortened (P < 0.001) and global longitudinal strain (GLS) was lower (P < 0.001). The thrombolysis in myocardial infarction (TIMI) frame count was negatively correlated with LV twist, LV torsion and apical rotation (P = 0.002, r = -0.624; P = 0.002, r = -0.624; and P = 0.002, r = -0.632, respectively).


CONCLUSIONS
We demonstrated that LV twist mechanics are impaired in CSF patients. Worse LV twist parameters were associated with greater TIMI frame count.
Faculty of Medicine, Department of Cardiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Ahmet
A
Barutçu
Faculty of Medicine, Department of Cardiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Adem
A
Bekler
Faculty of Medicine, Department of Cardiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Ahmet
A
Temiz
Faculty of Medicine, Department of Cardiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Bahadır
B
Kırılmaz
Faculty of Medicine, Department of Cardiovascular Surgery, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Ali Ümit
AÜ
Yener
Faculty of Medicine, Department of Nuclear Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Yusuf Ziya
YZ
Tan
Faculty of Medicine, Department of Cardiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Emine
E
Gazi
Faculty of Medicine, Department of Cardiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
Burak
B
Altun
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D003287:Contrast Media; D003331:Coronary Vessels / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007089:Image Enhancement; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055815:Young Adult
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
coronary slow flow; left ventricle torsion; left ventricle twist; speckle-tracking echocardiography