Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, 620061, Liaoning Province, China.
Department of Cardiology, The Sanmenxia Central Hospital, Sanmenxia, Henan Province, China.
Sci Rep. 2021 Apr 5;11(1):7511. doi: 10.1038/s41598-021-87193-z.
The coronary slow flow phenomenon (CSFP) is common in coronary angiography, however its impact on left atrial (LA) function is still controversial. This study aims to evaluate the LA structure and function of patients with CSFP using two-dimensional speckle tracking echocardiography (2D-STE). Consecutive patients scheduled for coronary angiography from January 2016 to September 2017 were enrolled in this study. Patients' demographic data, clinical histories, laboratory and angiographic findings were collected and recorded. Diagnostic criteria for CSFP is based on Beltrame et al. proposed in 2012. Meanwhile 139 patients who have no significant stenosis (≤ 40%) and normal blood flow were selected as control. All patients received an echocardiographic examination 24 h before coronary angiography. LA structure and function were measured with echocardiography and 2D-STE. Our results showed that among the 1,954 patients who had received coronary angiography, 512 patients were included in the analysis after the exclusion criteria was implemented. Of those, 101 patients met the CSFP criteria (5.5%). CSFP is mainly seen in LAD (~ 70%). There was no statistical difference in baseline characteristics between the CSFP group and control group, except for a higher proportion of smokers in the CSFP group (P = 0.001). The percentage of monocytes is an independent risk factor for the occurrence of CSFP (P = 0.036) after binary logistic regression analysis. The LA global longitudinal strain (LA-GLS, represents reservoir functions) decreased and LA strain rate at late diastole (LA-SRa, represents booster function) increased in patients with CSFP compared to the control group (P < 0.05). Correlation test of continuous variables by Pearson test suggested that LA-GLS was negatively correlated with TIMI frame count (TFC). We concluded that the percentage of monocytes is an independent risk factor for the CSFP; the LA reservoir and booster functions were impaired in patients with CSFP; LA-GLS is negatively correlated with TFC.
冠状动脉慢血流现象（CSFP）在冠状动脉造影中很常见，但它对左心房（LA）功能的影响仍存在争议。本研究旨在使用二维斑点追踪超声心动图（2D-STE）评估 CSFP 患者的 LA 结构和功能。本研究纳入了 2016 年 1 月至 2017 年 9 月期间因冠状动脉造影而接受治疗的连续患者。收集并记录了患者的人口统计学数据、临床病史、实验室和血管造影结果。CSFP 的诊断标准基于 Beltrame 等人 2012 年提出的标准。同时，选择了 139 名无明显狭窄（≤40%）和正常血流的患者作为对照组。所有患者在冠状动脉造影前 24 小时内接受超声心动图检查。使用超声心动图和 2D-STE 测量 LA 结构和功能。我们的研究结果显示，在接受冠状动脉造影的 1954 名患者中，排除标准实施后，有 512 名患者纳入分析。其中，101 名患者符合 CSFP 标准（5.5%）。CSFP 主要发生在 LAD（~70%）。CSFP 组和对照组之间的基线特征除 CSFP 组吸烟者比例较高外（P=0.001），无统计学差异。二元逻辑回归分析后，单核细胞百分比是 CSFP 发生的独立危险因素（P=0.036）。与对照组相比，CSFP 患者的左房整体纵向应变（LA-GLS，代表储备功能）降低，左房晚期应变率（LA-SRa，代表增强功能）增加（P<0.05）。通过 Pearson 检验对连续变量进行相关性检验表明，LA-GLS 与 TIMI 帧数（TFC）呈负相关。我们得出结论，单核细胞百分比是 CSFP 的独立危险因素；CSFP 患者的 LA 储备和增强功能受损；LA-GLS 与 TFC 呈负相关。
