The effect of coronary slow flow on left atrial structure and function

Area of Science:

• Cardiology
• Echocardiography
• Clinical Medicine

Background:

• Coronary slow flow phenomenon (CSFP) is frequently observed during coronary angiography, but its effects on left atrial (LA) function remain debated.
• Understanding CSFP's impact on LA structure and function is crucial for comprehensive cardiovascular assessment.

Purpose of the Study:

• To investigate the association between CSFP and LA structure and function using two-dimensional speckle tracking echocardiography (2D-STE).
• To identify potential risk factors for CSFP and correlate echocardiographic findings with angiographic parameters.

Main Methods:

• Prospective enrollment of patients undergoing coronary angiography, with CSFP diagnosis based on established criteria.
• Echocardiographic assessment, including 2D-STE for LA strain and strain rate analysis, performed 24 hours prior to angiography.
• Comparison of LA function parameters between patients with CSFP and a control group with normal coronary flow.

Main Results:

• Out of 1,954 patients, 101 (5.5%) had CSFP, predominantly in the LAD artery.
• Higher monocyte percentage was identified as an independent risk factor for CSFP.
• Patients with CSFP exhibited reduced LA global longitudinal strain (LA-GLS, reservoir function) and increased LA strain rate at late diastole (LA-SRa, booster function) compared to controls.
• LA-GLS showed a negative correlation with TIMI frame count (TFC).

Conclusions:

• Monocyte percentage is an independent risk factor for developing CSFP.
• CSFP is associated with impaired LA reservoir and booster functions.
• LA global longitudinal strain is negatively correlated with angiographic measures of coronary flow (TFC).