Impairment of coronary flow and left ventricular function in patients with slow coronary flow phenomenon and other types of microvascular angina

Purpose: We aimed at assessing the impairment in coronary flow and left ventricular function in patients without obstructive coronary disease on anti-ischemic treatment admitted with diagnosis unstable angina. Material and methods: The epicardial coronary flow was evaluated in 71 patients with unstable angina in absence of coronary stenosis >50% applying the methods the corrected TIMI frame count and systolic arrest of coronary flow at coronary angiography. The abnormalities in the diastolic function were assessed by echocardiography using PW-Doppler of the diastolic mitral flow and tissue Doppler imaging. Results: The early diastolic velocity of interventricular septum (E’sept) and left ventricular free wall (E’ lat) were reduced in the SF LVH group compared to SCFP and the patients with normal coronary flow. Significant difference was found in between the patients with SF LVH and SCFP regarding DT and A-wave velocity in sub-analysis. The epicardial coronary flow of the patients with SF LVH was as tendency impaired compared to SCFP. The therapy with β- blocker alone or combined with calcium channel blocker or nitrate did not influence either cardiac function or coronary flow in this analysis. Conclusion: Slower left ventricular relaxation is typical for the patients with microvascular angina and left ventricular hypertrophy associated with hypertension on treatment compared to SCFP and patients with normal coronary flow.