J Cardiovasc Imaging.  2021 Oct;29(4):347-356. 10.4250/jcvi.2020.0185.

Evolution of Diastolic Dysfunction in Patients with Coronary Slow Flow Phenomenon and Acute Non-ST Segment Elevation Myocardial Infarction

• Ahmed EZ
• Mahmoud A
• Ahmed Y
• Ismail I

• KMID: 2522176
• DOI: http://doi.org/10.4250/jcvi.2020.0185

Abstract

BACKGROUND
Diastolic function has been reported to be impaired in many patients with coronary slow flow phenomenon (CSFP). CSFP has broad spectrum of clinical presentations, including non-ST elevation myocardial infarction (NSTEMI). We sought to study the shortterm evolution of diastolic function in CSFP patients presenting with NSTEMI.
METHODS
This study included 92 patients with CSFP and acute NSTEMI. Conventional echocardiography Doppler imaging and tissue Doppler echocardiography imaging were used to evaluate diastolic function during index NSTEMI and after 3 months.
RESULTS
Mean age of study patients was 45.7 ± 6.8 years. The prevalence of diastolic dysfunction (DD) at baseline was 69 patients (75%) and 28 patients (30.4%) at 3 months, p < 0.001. Various diastolic function indices showed significant improvement from baseline to 3 months follow-up. E/Em was 17.32 ± 3.41 at baseline compared to 12.41 ± 5.58 at 3 months, p = 0.039. Septal e′ velocity was 5.67 ± 4.56 cm/s at baseline compared to 7.78 ± 3.22 cm/s at 3 months, p = 0.023. Medications used were not significantly different between those with improved versus unimproved DD.
CONCLUSIONS
Diastolic function seems to improve over short-term follow-up in patients with CSFP presenting with NSTEMI. This could reflect a transient worsening during acute NSTEMI.

Keyword

Coronary slow flow; Non-ST elevation myocardial infarction; Microvascular dysfunction; Diastolic dysfunction