Diagnostic Indicators of ECG for Coronary Slow Flow Phenomenon; a Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Diagnostic Imaging
• Clinical Electrophysiology

Background:

• Coronary Slow Flow Phenomenon (CSFP) diagnosis currently relies solely on epicardial coronary angiography.
• There is a need for non-invasive diagnostic tools to identify CSFP.

Purpose of the Study:

• To systematically review and compare Electrocardiogram (ECG) findings in patients with and without CSFP.
• To identify potential ECG markers for CSFP diagnosis.

Main Methods:

• Systematic literature search of MEDLINE, Scopus, Embase, and Web of Science up to February 2023.
• Meta-analysis of 32 studies with 3,937 patients (2,069 with CSFP) using random-effect models.
• Calculation of mean differences and odds ratios for various ECG parameters.

Main Results:

• CSFP patients exhibited significantly higher P-wave maximum (Pmax) and P-dispersion (Pd).
• Prolonged durations were observed for QT wave, uncorrected QTd, and corrected dispersion (QTcd) in the CSFP group.
• Elevated frontal QRS-T angle and T-peak to T-end (Tp-e) intervals were noted in CSFP patients.

Conclusions:

• Several ECG parameters, including Pmax, Pd, QT, QTc, QTd, QTcd, Tp-e, and frontal QRS-T angle, are significantly altered in CSFP.
• These ECG findings show potential as non-invasive diagnostic indicators for CSFP, preceding coronary angiography.