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Evaluation of left atrial volume and function in patients with coronary slow flow phenomenon using real-time

Yumeng Xing1, Yongle Chen1, Yu Liu1

  • 1Department of Echocardiography, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.

The International Journal of Cardiovascular Imaging
|July 27, 2019
PubMed

Insights

Coronary slow flow phenomenon (CSFP) is linked to enlarged left atrial (LA) volumes and altered LA functions, detectable with real-time three-dimensional echocardiography (RT3DE). This imaging technique aids in identifying subtle cardiac changes in CSFP patients with normal ejection fraction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Coronary slow flow phenomenon (CSFP) affects myocardial perfusion without obstructive coronary artery disease.
  • Left atrial (LA) function plays a crucial role in cardiovascular health.
  • Preserved left ventricular ejection fraction (LVEF) is common in CSFP, necessitating evaluation of other cardiac chambers.

Purpose of the Study:

  • To assess left atrial (LA) volume and phasic functions in patients with coronary slow flow phenomenon (CSFP) and preserved left ventricular ejection fraction (LVEF).
  • To investigate the utility of real-time three-dimensional echocardiography (RT3DE) in detecting LA alterations in CSFP.
  • To correlate LA dynamics with coronary flow parameters in CSFP patients.

Main Methods:

  • Prospective enrollment of 56 CSFP patients and 48 controls.
  • Comprehensive transthoracic echocardiography and RT3DE for LA volume and function assessment.
  • Measurement of LA maximum, minimum, and pre-atrial contraction volumes (LAV-max, LAV-min, LAV-preA) and emptying fractions.

Main Results:

  • CSFP patients exhibited significantly higher LA volumes (LAV-max, LAV-min, LAV-preA, LAVi-max) compared to controls.
  • LA emptying volumes and fractions (total and active) were altered in CSFP patients.
  • Positive correlations were observed between coronary slow flow severity (using TIMI frame count) and LA volumetric parameters.

Conclusions:

  • CSFP is associated with enlarged LA volumes and impaired LA reservoir and conduit functions, alongside enhanced LA contractile function.
  • RT3DE is valuable for recognizing subtle myocardial alterations related to CSFP by evaluating LA dynamics.
  • These findings highlight the importance of assessing LA function in CSFP management.

Keywords:
Coronary slow flow phenomenonLeft atriumReal-time three-dimensional echocardiography

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