title: Left Ventricular Myocardial Deformation Parameters Are Affected by Coronary Slow Flow Phenomenon: A Study of Speckle Tracking Echocardiography.
abstract: BACKGROUND
  The coronary slow flow phenomenon (CSFP) is defined as a delayed distal vessel contrast opacification in the absence of obstructive epicardial coronary artery disease during coronary angiography. There is conflicting data in medical literature regarding the effects of CSFP on the left ventricular functions assessed by conventional echocardiography or tissue Doppler imaging. Therefore, we aimed to evaluate whether there is any abnormality in the myocardial deformation parameters (strain, strain rate (SR), rotation, twist) of the left ventricle obtained by speckle tracking echocardiography (STE) in patients with CSFP.
  
  
  METHODS
  Twenty patients with CSFP were included prospectively in the study. Another 20 patients with similar demographics and cardiovascular risk factors as well as normal coronary angiography were used as the control group. Two-dimensional echocardiographic images of the left ventricle from the apical long-axis, two-chamber, four-chamber, and parasternal short-axis views were used for STE analysis.
  
  
  RESULTS
  The analysis of left ventricular circumferential deformation parameters showed that the averaged peak systolic strain, systolic SR, and early diastolic SR values were significantly lower in patients with CSFP (P = 0.009, P = 0.02, and P = 0.02, respectively). Among the left ventricular rotation and twist values, apical rotation was significantly lower in patients with CSFP (P = 0.02). Further, the mean thrombolysis in myocardial infarction frame count value was found to be negatively correlated with the averaged peak circumferential early diastolic SR (r = -0.35, P = 0.03). It was positively correlated with the averaged peak circumferential systolic strain (r = 0.47, P = 0.003) and circumferential systolic SR (r = 0.46, P = 0.005).
  
  
  CONCLUSIONS
  Coronary slow flow phenomenon leads to significant alterations in the myocardial deformation parameters of the left ventricle as assessed by STE. Specifically, circumferential deformation parameters are affected in CSFP patients.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Gulel
authors.affiliation: Cardiology Clinic, Terme State Hospital, Samsun, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akcay
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Korhan
authors.initials: K
authors.lastname: Soylu
authors.affiliation: Cardiology Clinic, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Aksan
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Yuksel
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Zengin
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Meric
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Sahin
mesh_terms: D019245:Compressive Strength; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D013718:Tensile Strength; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*
keywords: coronary slow flow phenomenon; rotation; strain; strain rate; twist