A novel echocardiographic method as an indicator of endothelial dysfunction in patients with coronary slow flow

BACKGROUND: To improve clinical outcomes, noninvasive imaging modalities have been proposed to measure and monitor atherosclerosis. Endothelial dysfunction is considered the first stage in the development of atherosclerosis. Brachial artery flow-mediated dilatation (FMD) has been impaired in patients with coronary slow flow (CSF). Recently, color M-mode derived propagation velocity of descending thoracic aorta (aortic propagation velocity-AVP) was shown to be an ultrasonographic marker for atherosclerosis. AIM: To assess endothelial function in patients with CSF and the correlation of AVP with FMD. MATERIALS AND METHODS: FMD and AVP were measured in 90 patients with CSF and 39 patients having normal coronary arteries (NCA) detected by coronary angiography. RESULTS: Compared to patients with normal coronary arteries patients having CSF had significantly lower AVP (39.1 +/- 8.4 vs. 53.7 +/- 12.7 cm/s, p < 0.001) and FMD (5.6 +/- 3.2 vs. 17.6 +/- 4.4 %, p < 0.001) measurements. There were significant correlations between AVP and FMD (r = 0.524, p < 0.001). CONCLUSIONS: Transthoracic echocardio-graphic determination of color M-mode propagation velocity of descending aorta is a simple practical method and correlates well with coronary slow flow and brachial endothelial function.